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Updated: Jan 20, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Carotid artery stenting is safe and effective for symptomatic patients with acute coronary syndrome
Renato Casana1,2, Valerio Stefano Tolva3, Andrea Odero1
1Istituto Auxologico Italiano, IRCCS, Department of Surgery, Milan, Italy.
Insights
Carotid artery stenting (CAS) is a safe and effective treatment for patients with symptomatic carotid stenosis and acute coronary syndrome (ACS). While short-term outcomes were similar, long-term follow-up showed higher death and myocardial infarction rates in ACS patients.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Patients with symptomatic carotid stenosis undergoing percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS) face high surgical risks due to the need for uninterrupted dual antiplatelet therapy.
- Carotid artery stenting (CAS) emerges as a potentially safer alternative for this high-risk group.
Purpose of the Study:
- To evaluate and compare the outcomes of carotid artery stenting (CAS) in symptomatic patients with and without a recent history of acute coronary syndrome (ACS).
Main Methods:
- A single-institution study included 151 consecutive symptomatic patients who underwent CAS between 2010 and 2017.
- Sixty-six patients (43.7%) had a recent history of ACS.
- Follow-up included carotid duplex ultrasound and neurological assessment for up to 3 years post-procedure.
Main Results:
- Short-term follow-up showed no significant differences in death, stroke, myocardial infarction (MI), or restenosis rates between patients with and without ACS.
- Long-term follow-up revealed significantly higher rates of death (11.4% vs. 5.4%) and MI (11.4% vs. 3.6%) in patients with ACS.
- These long-term disparities are attributed to the complex comorbidities in the ACS patient cohort.
Conclusions:
- Carotid artery stenting (CAS) demonstrates safety and efficacy in treating symptomatic carotid artery stenosis, even in patients recently treated for ACS requiring dual antiplatelet therapy.
- The study highlights the importance of considering long-term outcomes, particularly in ACS patients with complex conditions.
Background:
Patients with symptomatic carotid stenosis recently treated with percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS) are always classified as at high risk for surgery, given that they are required uninterrupted dual antiplatelet therapy. In this regard, carotid artery stenting (CAS) may represent a valid alternative.
Objective:
The purpose of this study is to overview CAS outcomes in symptomatic patients with and without ACS.
Methods:
One hundred fifty-one consecutive symptomatic patients who underwent CAS between 2010 and 2017 in a single institution were included in this study, of which 66 (43.7%) were identified as having ACS. All patients were followed-up with carotid duplex ultrasound scan and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up after that for 3 years.
Results:
Among symptomatic ACS patients, common risks factors were active smoking, metabolic syndrome, diabetes, and hypertension. In the short-term follow-up, no significant differences were observed among rates of death, stroke, myocardial infarction (MI), and restenosis, between patients with and without ACS. Mean clinical follow-up was 28.2 (12.3) months. In the long-term follow-up, higher rates of death and MI were recorded in patients with ACS (death: 11.4% vs. 5.4%, p = .04; MI: 11.4% vs. 3.6%, p = .02), owing to the complexity of these patients.
Conclusions:
This single-center study suggested that CAS is a safe and effective treatment for patients with symptomatic carotid artery stenosis, who recently underwent PTCA for ACS, requiring uninterrupted dual antiplatelet therapy.
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