Carotid artery stenting has been accepted as a potential alternative to car
otid endarterectomy in patients with significant carotid artery stenosis. T
he objective of this study was to evaluate the feasibility, safety and long
-term outcome of percutaneous stenting of carotid artery stenosis in patien
ts with coexisting symptomatic coronary disease. Between May 1996 and May 1
999, we performed carotid artery stenting at 48 lesions in 36 patients with
carotid stenosis of 60% and symptomatic coronary artery stenosis. Twenty-o
ne patients (58%) had neurologic symptoms. Carotid stenting was performed i
n 43 internal, 2 external and 3 common carotid lesions. We used Wallstent i
n 46 lesions, Palmaz stent in 2 lesions and Microstent II in 1 lesion. Stag
ed or combined coronary intervention was performed in 18 patients (50%) and
staged coronary artery bypass surgery was performed in 6 patients (17%). I
n the other 12 patients (33%), medical treatments were performed. Carotid s
tenting was successful in all lesions. Simultaneous bilateral carotid stent
ing was performed in 11 patients (31%). One major and 1 minor stroke develo
ped during the procedure. There were no deaths during the procedures and wi
thin 30 days post-procedure. During the follow-up of 14+/-7 (3 to 40) month
s, there were no deaths or neurological events. On follow-up (6+/-1 months)
angiography and/or duplex sonography of 44 eligible lesions in 32 patients
, there were 2 cases of asymptomatic restenosis (4.5%) which developed in P
almaz stents implanted at the external carotid artery and the common caroti
d artery, respectively. In conclusion, carotid artery stenting in patients
with coexistent carotid and coronary artery disease is feasible, safe and s
hows favorable follow-up outcomes.