The Feasibility and Safety of Separate Carotid Artery Stenting Using the Restrict Protective Method for Bilateral Carotid Stenosis.
OBJECTIVE
The treatment strategy for bilateral carotid stenosis (BCS) is not clear. We report our experience of treating 12 patients with BCS using separate carotid artery stenting (CAS) using the restrict protective method. The order of treatment site and the protective method are also discussed.


METHODS
Between April 2012 and November 2016, 24 lesions in 12 patients (range, 44-83 years; mean, 71 years; 1 woman) underwent CAS at Kariya Toyota General Hospital. These cases were reviewed retrospectively. In all cases, CAS was first performed on the more severely stenosed site. All procedures were performed using the proximal protective method involving balloons and a filter device. We took into consideration adverse events including death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from any stroke.


RESULTS
All procedures were successfully performed under local anesthesia. There was not a single case that showed intolerance during flow arrest to prevent distal embolisms. We observed no adverse events, restenosis, or recurrent symptoms during follow-up.


CONCLUSIONS
Good outcomes can be achieved in patients with BCS when attempting separate CAS using the restrict protective method.
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan. Electronic address: tomotaka.oshima@toyota-kai.or.jp.
Tomotaka
T
Ohshima
Department of Neurosurgery, Maharaja Agarsen Medical College, Agroha, Hisar, Haryana, India; Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
Ishu
I
Bishnori
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Kojiro
K
Ishikawa
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Shunsaku
S
Goto
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Taiki
T
Yamamoto
Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
Yoko
Y
Kato
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000077144:Clopidogrel; D016894:Endarterectomy, Carotid / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018608:Ultrasonography, Doppler
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
Bilateral carotid stenosis; Carotid artery stenting; Proximal protection