ELECTIVE STENTING OF CAROTID-ARTERY STENOSIS IN PATIENTS WITH SEVERE CORONARY-ARTERY DISEASE

Aims To evaluate the feasibility and safety of elective carotid stent implantation in patients with carotid stenoses and concomitant coronar y artery disease, as an alternative to combined carotid and coronary s urgery. Methods We treated 50 patients with >70% stenoses in 53 caroti d arteries with balloon angioplasty followed by elective stent implant ation. All patients had severe coronary artery disease, and/or mitral insufficiency, aortic stenosis, rhythm disorders or generalized arteri osclerosis. In three patients the opposite carotid artery was occluded ; nine patients had bilateral stenoses of which two received stents bi laterally. Results Fifty-six successful stent implantations (42 Wallst ents, eight BeStents, two AVE-Microstents, one Palmaz Schatz stent, th ree Site stents) were performed, reducing the baseline percent stenosi s from 78 +/- 18% to 13 +/- 11%. Complications included three transien t ischaemic attacks, one minor and one major stroke. Follow-up was ava ilable for 46 patients over a mean of 10 months. Three asymptomatic re stenoses and one deformation of a BeStent occurred. Conclusion Our pre liminary results indicate that carotid artery stenting in patients wit h concomitant severe coronary artery disease is feasible, safe, and ma y be an alternative to combined carotid and coronary surgery.