Simultaneous bilateral carotid stenting in high-risk patients
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Korea.
AJNR. American Journal of Neuroradiology
|January 8, 2010
Summary
Bilateral carotid artery stenting (CAS) showed no significant difference in 6-month outcomes compared to unilateral CAS in high-risk patients. However, Hemorrhagic Posterior Stroke (HPS) was more frequent after bilateral CAS.
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- The safety and efficacy of bilateral carotid artery stenting (CAS) require further evaluation.
- High-risk patients undergoing CAS present unique challenges for procedural success and patient outcomes.
Purpose of the Study:
- To compare the outcomes of bilateral CAS versus unilateral CAS in high-risk patients.
- To assess stroke risk, procedural results, and restenosis rates at 6 months post-stenting.
Main Methods:
- A retrospective analysis of 205 high-risk patients undergoing CAS between March 2002 and October 2008.
- Comparison of 30 patients who underwent bilateral CAS (SBCAS) with 175 patients who underwent unilateral CAS.
- Statistical analysis using chi-squared or Kruskal-Wallis tests to compare outcomes, including stroke, death, and restenosis rates.
Main Results:
- No significant differences in stroke risk factors were observed between the bilateral and unilateral CAS groups.
- Hemorrhagic Posterior Stroke (HPS) occurred significantly more frequently in the bilateral CAS group (16.7%) compared to the unilateral CAS group (2.9%).
- There were no statistically significant differences in the rates of stroke (minor/major), death, or restenosis at 6 months between the two groups.
Conclusions:
- Bilateral CAS did not demonstrate a significant difference in 6-month outcomes compared to unilateral CAS in high-risk patients.
- Despite similar overall outcomes, the increased incidence of HPS after bilateral CAS warrants consideration in patient selection and procedural management.