Simultaneous stenting of the carotid artery and other coronary or extracoronary arteries: does a combined procedure increase the risk of interventional therapy?
Simultaneous interventions in carotid and other extracarotid arteries are not performed on a routine basis up to now. In 67 out of 295 consecutive patients (23%) undergoing elective stenting of the internal carotid artery, additional interventions in the coronary arteries (n = 65), the iliac artery (n = 3), renal artery (n = 1), left subclavian artery (n = 3), vertebral artery (n = 4), or a combination thereof were performed. Primary stenting was done in 51 (74%) out of 69 carotid arteries, in 48 (74%) of 65 coronary arteries, and in 10 (91%) of 11 other targeted vessels. Neurological complications consisted of two (2.9%) transient ischemic attacks and one (1.5%) minor stroke. In addition, one (1.5%) myocardial infarction occurred during coronary artery intervention. In comparison, 16 (6.6%) transient ischemic attacks, 1 minor stroke (0.4%), 5 (2.2%) major strokes, and 3 (1.2%) deaths were observed in 228 patients without combined procedures. Simultaneous percutaneous interventions including carotid arteries and other extracarotid arteries are feasible, relatively safe, and cost-effective.
Cardiovascular Division, City-Hospital Linz, Linz, Austria. robert.hofmann@akh.linz.at
Robert
R
Hofmann
Klaus
K
Kerschner
Alexander
A
Kypta
Clemens
C
Steinwender
Dietmar
D
Bibl
Franz
F
Leisch
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001158:Arteries / Q000473:pathology* / Q000601:surgery*; D001317:Austria / Q000453:epidemiology; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery*; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome