title: Safety of balloon pre-dilatation in the treatment of severe carotid artery stenosis.
abstract: OBJECTIVE
  To assess early outcome of predilatation prior stenting of severe carotid artery stenosis and to evaluate early major adverse cardiovascular and cerebral events (MACCE).
  
  
  METHODS
  The study group consisted of 265 consecutive patients (200 males, 65 female, mean age 66.7 ± 8.6 years) in whom 275 percutaneous transluminal angioplasty (PTA) procedures of carotid arteries were performed. Staged carotid stenting was performed in patients with bilateral carotid stenosis. Neuroprotection with a distal protection device was used in all cases. The patients were divided into two groups: direct carotid stent implantation without previous pre-dilation was performed in 233 patients (direct stenting group) and predilatation was performed in 42 patients (predilatation group). Early events were recorded and analyzed subsequently.
  
  
  RESULTS
  We treated 275 carotid stenoses and the stent was implanted in all patients. Ten patients (3.7%) were treated by staged carotid artery stenting (CAS) due to bilateral carotid artery disease. The technical success rate was 97.1%. During 1-month follow-up, the prevalence of primary endpoint was 2.18%. The prevalence of MACCE at 30 days was higher in the predilatation group (2.4% vs. 2.1%; p = 0.924). Also periprocedural rate of hypotension was higher in predilatation group (7.1% vs. 1.7%; p = 0.04).
  
  
  CONCLUSIONS
  Balloon predilatation prior to stenting can be performed to treat severe carotid artery stenosis with acceptable periprocedural complication rate.
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Heart-Education and Research Hospital, Istanbul, Turkey. gokselacar81@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.forename: M V
authors.initials: MV
authors.lastname: Yazicioglu
authors.forename: G
authors.initials: G
authors.lastname: Acar
authors.forename: S
authors.initials: S
authors.lastname: Demir
authors.forename: M E
authors.initials: ME
authors.lastname: Kalkan
authors.forename: B
authors.initials: B
authors.lastname: Ozkan
authors.forename: G
authors.initials: G
authors.lastname: Alici
authors.forename: T
authors.initials: T
authors.lastname: Akgun
authors.forename: M
authors.initials: M
authors.lastname: Akcakoyun
authors.forename: B
authors.initials: B
authors.lastname: Boztosun
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods*; D016893:Carotid Stenosis / Q000601:surgery*; D004106:Dilatation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male