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19 August 2016 : Clinical Research  

Simultaneous Bilateral Carotid Stenting for Symptomatic Bilateral High-Grade Carotid Stenosis: A Retrospective Clinical Investigation

Ziming YeABCDEF, Ying LiuABCDEF, Xiao DengBD, Xiangren ChenBD, Cuiting LinBD, Yanyan TangBD, Ying SuBD, Lanji FangABDE, Yuan WuABDE, Chao QinABCDEG

DOI: 10.12659/MSM.896505

Med Sci Monit 2016; 22:2924-2933

Abstract

BACKGROUND: This retrospective clinical investigation aimed to evaluate the short-term effectiveness and safety of SBCAS for symptomatic bilateral high-grade CS.

MATERIAL AND METHODS: From 2009 to 2014, 145 patients were recruited. Among them, 70 underwent SBCAS, and other 75 patients underwent SAMM and served as controls. The immediate postprocedural complications and postprocedural neurological evaluation, as well as restenosis at 6-month and 1-year follow-ups in the SBCAS group are reported. Additionally, baseline risk factors for ischemic stroke, adverse effects of drugs, and outcomes at 30-day, 6-month, and 1-year follow-ups were compared between the 2 groups.

RESULTS: Our data did not reveal significant differences between the 2 groups in baseline risk factors for ischemic stroke. In the SBCAS group, both HPS (5.7%) and HD (40%) occurred, but they were not very severe, and no patients had postprocedural neurological deficit. Moreover, restenosis only occurred in 3 patients at 3 stent placement sites (4.3%) at 1-year follow-up. Adverse effects of drugs did not occur in SBCAS group, but adverse effects of Bayer aspirin and Lipitor occurred in 4 patients (5.4%) and 18 patients (24.3%), respectively, at 6-month follow-up in the control group. Furthermore, there were significant differences in outcomes between the 2 groups at 30-day, 6-month, and 1-year follow-ups, in that NIHSS, CS ratio, and incidence of endpoint events, as well as 1-year cumulative probability of endpoint events, were all lower in the SBCAS group than in the control group (p<0.05).

CONCLUSIONS: Compared to SAMM, we found that SBCAS was more effective and safer for symptomatic bilateral high-grade CS.

Keywords: Carotid Stenosis - therapy, Aged, 80 and over, Case-Control Studies, Endarterectomy, Carotid, Ischemic Attack, Transient - diagnosis, Risk Factors, Stents, Stroke - diagnosis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750