Simultaneous Bilateral vs Unilateral Carotid Artery Stenting: 30-Day and 1-Year Results. (April 2016)

• Record Type: Journal Article
• Authors: Jiang, Xiong-jing; Dong, Hui; Peng, Meng; Zou, Yu-bao; Song, Lei; Xu, Bo; Zhang, Hui-min; Wu, Hai-ying; Zhou, Xian-liang; Yang, Yue-jin; Gao, Run-lin
• Is Part Of: Journal of endovascular therapy. Volume 23:Number 2(2016:Apr.)
• Page Start: 258
• Page End: 266
• Publication Date: 2016-04
• Subjects: carotid artery -- carotid artery stenting -- death -- embolic protection -- myocardial infarction -- stenosis -- stent -- stroke -- symptom status; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602815626900
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To evaluate clinical outcomes of simultaneous bilateral carotid artery stenting (sbCAS) compared with unilateral CAS (uCAS).Methods: The database in our institution was queried to identify all patients treated with CAS from January 2005 to December 2012. In this time frame, 120 (18.8%) patients (mean age 64.9±7.7 years; 96 men) underwent sbCAS and 517 (81.2%) patients (mean age 65.7±7.7 years; 421 men) received uCAS. The primary endpoint was the composite of stroke, myocardial infarction, or death within 30 days or any ipsilateral stroke within 1 year.Results: There was no significant difference in the rates of the primary endpoint between the sbCAS and uCAS groups (6.7% vs 4.6%, p=0.358). The rates of the primary endpoint among symptomatic patients was 8.0% in the sbCAS group and 5.0% in the uCAS group (p=0.299) and 3.1% and 4.0%, respectively (p=0.821) among asymptomatic patients. During the 30-day periprocedural period, the rates of the primary endpoint did not differ significantly between the sbCAS and uCAS groups among all patients (5.8% vs 4.4%, p=0.479), symptomatic patients (6.8% vs 5.0%, p=0.594), or asymptomatic patients (3.1% vs 3.5%, p>0.999). After this period, the incidences of any ipsilateral stroke were similarly low (0.8% and 0.2%, respectively; p=0.342).Conclusion: The study showed that simultaneous bilateral CAS had no more adverse events than unilateral CAS during the periprocedural period or within 1 year. This 1-stage strategy may become a valuable alternative in the treatment of patients with severe bilateral carotid stenosis.