title: Comparison of the safety of simultaneous bilateral carotid artery stenting versus unilateral carotid artery stenting: 30-day and 6-month results.
abstract: BACKGROUND
  Severe bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly. Such patients have high stroke risk. Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis. However, the optimal procedural strategy of bilateral carotid stenosis remains unclear. The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).
  
  
  METHODS
  In this single-center retrospective study, we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009. Thirty-nine patients (16.7%) of them underwent SBCAS, and the others (n = 195) underwent UCAS. Indication for CAS was defined as carotid artery diameter reduction > 60% (symptomatic) or > 80% (asymptomatic). Six-month and 30-day hemodynamic depression (HD), hyperperfusion syndrome (HPS), stroke, death and myocardial infarction (MI) after carotid stenting were assessed.
  
  
  RESULTS
  SBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD: 28.2% vs. 20.0%, P = 0.396; HPS: 2.6% vs. 2.1%, P = 0.262). Moreover, there was no statistically significant difference between SBCAS group and UCAS group in major stroke, death, MI and their combinations within 30 days (major stroke: 0 vs. 3.6%, P = 0.604; death: 2.6% vs. 1.5%, P = 0.520; MI: 2.6% vs. 0.5%, P = 0.306; and their combinations: 5.1% vs. 4.6%, P = 1.000) and 6 months (major stroke: 0 vs. 3.6%, P = 0.604; death: 5.1% vs. 2.1%, P = 0.262; MI: 5.1% vs.1.0%, P = 0.130 and their combinations: 7.7% vs. 5.1%, P = 0.459).
  
  
  CONCLUSIONS
  The patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up. Our finding suggests that SBCAS appears to be as safe as UCAS.
authors.affiliation: Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Dong
authors.forename: Xiong-jing
authors.initials: XJ
authors.lastname: Jiang
authors.forename: Meng
authors.initials: M
authors.lastname: Peng
authors.forename: Wei
authors.initials: W
authors.lastname: Ji
authors.forename: Hai-ying
authors.initials: HY
authors.lastname: Wu
authors.forename: Ru-tai
authors.initials: RT
authors.lastname: Hui
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Yue-jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Run-lin
authors.initials: RL
authors.lastname: Gao
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors