[Percutaneous interventions combined with carotid artery stenting].

BACKGROUND AND OBJECTIVE

Although the value of interventional treatment of arterial stenosis has not been confirmed for all sites by randomized studies, these methods are used more and more, often for several arteries simultaneously. This study reports results of percutaneous carotid artery stenting combined with simultaneous interventions in other central arteries.

PATIENTS AND METHODS

Among 90 patients who had undergone percutaneous carotid artery stenting, 13 had simultaneous intervention in other arteries: contralateral carotid artery (n = 4), ipsilateral common carotid artery near its aortic origin (n = 1), left subclavian artery (n = 1), coronary artery (n = 6) and one of both carotid arteries and a coronary artery.

RESULTS

Primary success (restenosis < 30%) was achieved in all cases. Additional carotid artery stenting was done in 18. Stents were also implanted in eight coronary arteries, angioplasty without stenting in two. Mean stenosis of the carotid arteries was reduced from 85 +/- 10% to 3 +/- 6%, that of the coronary arteries from 90 +/- 10% to 9 +/- 10%. Serious complications, a major stroke, occurred in one of the 13 patients (7.7%). Minor complications were seen in two patients: transitory ischaemic attack in one, small myocardial infarction in the other.

CONCLUSION

Carotid artery stenting combined with simultaneous intervention in other central arteries can be done with a high rate of success and relatively few complications. This form of treatment should be considered in selected patients.