Interventional Cardiology and Angiology

Waigand J., Gross C.M. et al., Eur Heart Journal (in press)

• Aims
  • To evaluate the feasibility and safety of elective carotid stent implantation in patients with carotid stenoses and concomitant coronary artery disease as an alternative to combined carotid and coronary surgery.
• Methods
  • We treated 50 patients with >70% stenoses in 53 carotid arteries with balloon angioplasty followed by elective stent implantation. All patients had severe coronary artery disease, and/or mitral insufficiency, aortic stenosis, rhythm disorders or generalized arteriosclerosis. In 3 patients the opposite carotid artery was occluded; 9 patients had bilateral stenoses of which 2 received stents bilaterally.
• Results
  • Fifty-six successful stent implantations (42 Wallstents, 8 BeStents, 2 AVE-Microstents, 1 Palmaz Schatz stent, 3 Sito stents) were performed, reducing the base line percent stenosis from 78±18% to 13±11%. Complications included 3 transient ischemic attacks, one minor and one major stroke.
  • Follow-up was available for 46 patients over a mean of 10 months. Three asymptomatic restenoses and one deformation of a BeStent occurred.
• Conclusion
  • Our preliminary results indicate that carotid artery stenting in patients with concomitant severe coronary artery disease is feasible, safe, and may be an alternative to combined carotid and coronary surgery.