One Puncture, Two Solutions: Simultaneous Carotid and Iliac Artery Stenting

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Medicine

Background:

• Severe carotid artery stenosis poses a risk of stroke, while iliac artery stenosis can cause critical limb ischemia.
• Managing patients with concurrent stenosis in both territories presents a complex clinical challenge.
• Optimal revascularization strategies for combined carotid and iliac disease are actively investigated.

Observation:

• An 81-year-old male patient presented with asymptomatic severe carotid stenosis and symptomatic iliac artery stenosis.
• The patient underwent a staged, simultaneous bilateral carotid artery stenting (CAS) and iliac artery percutaneous transluminal angioplasty and stenting (IPTAS) procedure.
• Transfemoral access was utilized for sequential right iliac and right carotid interventions, followed by left-sided procedures.

Findings:

• The simultaneous CAS and IPTAS procedure was technically successful in both iliac and carotid arteries.
• The patient experienced no neurological deficits post-procedure and remained asymptomatic at six-month follow-up.
• This combined approach demonstrated feasibility and effectiveness in treating complex atherosclerotic disease affecting both vascular beds.

Implications:

• Simultaneous stenting of carotid and iliac arteries offers a comprehensive revascularization strategy.
• This approach may be a safe and effective option for select patients with concurrent severe stenosis in both territories.
• Further studies are warranted to establish the long-term outcomes and patient selection criteria for this combined intervention.