title: Barostim Implantation with Ipsilateral Carotid Endarterectomy as a One-Stage Procedure.
abstract: Clinical trials have demonstrated significant and lasting reductions in arterial pressure from baroreflex activation therapy (BAT), resulting from electrical stimulation of the carotid sinus in patients with resistant arterial hypertension. Significant carotid atherosclerosis, however, has been a contraindication for ipsilateral implantation due to a potentially increased risk of periprocedural stroke and uncertain antihypertensive efficacy. Here, we describe the first case in which BAT was applied safely and effectively in a patient with distinct cerebral arteriosclerosis after ipsilateral carotid endarterectomy as a one-stage procedure without neurologic complications. BAT resulted in satisfactory blood pressure levels despite distinct cerebral atherosclerosis after an 18-month follow-up period.
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany. Electronic address: kweipert@gmx.de.
authors.forename: Kay F
authors.initials: KF
authors.lastname: Weipert
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Most
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Doerr
authors.affiliation: Department of Cardiovascular Surgery, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Koshty
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Damir
authors.initials: D
authors.lastname: Erkapic
authors.affiliation: Division of Cardiology, Department of Internal Medicine I, Justus-Liebig University of Giessen, Giessen, Germany.
authors.forename: Joern
authors.initials: J
authors.lastname: Schmitt
mesh_terms: D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D062186:Arterial Pressure / Q000187:drug effects; D017704:Baroreflex; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D016894:Endarterectomy, Carotid; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D058542:Implantable Neurostimulators; D008297:Male; D011311:Pressoreceptors / Q000503:physiopathology*; D011474:Prosthesis Design; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents