title: Carotid artery stenting in patients with acute coronary syndrome: a possible primary therapy for symptomatic carotid stenosis.
abstract: OBJECTIVE
  To report the results of carotid artery stenting (CAS) in symptomatic patients (stroke/transient ischemic attack) after recent percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS).
  
  
  METHODS
  Between January 2009 and July 2011, 28 consecutive patients (18 women; mean age 66 years, range 42-82) underwent protected CAS for symptomatic carotid stenosis following recent PTCA that included bare or drug-eluting stents requiring uninterrupted dual antiplatelet therapy. Primary technical success, neurological complications, major adverse cardiovascular events, and death were evaluated at 30 days and over midterm follow-up.
  
  
  RESULTS
  Technical success was 96%; 1 patient suffered a nonfatal major stroke (3.5% 30-day stroke rate) during the procedure. During a median 21.6-month follow-up, 4 (14%) patients died of myocardial infarction (all diabetic smokers with ejection fractions <40%), but there were no new neurological events. Estimated survival was 89.3% at 2 years. Further coronary interventions were performed in 2 diabetic patients with a body mass index >34 kg/m(2).
  
  
  CONCLUSIONS
  This preliminary experience demonstrated that CAS is a reasonable, safe, and effective treatment for patients with symptomatic carotid artery stenosis who were recently treated with coronary stents requiring uninterrupted dual antiplatelet therapy.
authors.affiliation: Department of Surgery, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Casana
authors.forename: Alison
authors.initials: A
authors.lastname: Halliday
authors.forename: Paolo
authors.initials: P
authors.lastname: Bianchi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Fresa
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Silani
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Simonetta
authors.initials: S
authors.lastname: Blengino
authors.forename: Lea
authors.initials: L
authors.lastname: Cireni
authors.forename: Laura
authors.initials: L
authors.lastname: Adobbati
authors.forename: Laura
authors.initials: L
authors.lastname: Calvillo
authors.forename: Valerio S
authors.initials: VS
authors.lastname: Tolva
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D015607:Stents