Carotid artery stenting is safe and effective for symptomatic patients with acute coronary syndrome.

Autor: Casana R; Istituto Auxologico Italiano, IRCCS, Department of Surgery, Milan, Italy.; Istituto Auxologico Italiano, IRCCS, Laboratory of Research in Vascular Surgery, Milan, Italy., Tolva VS; Department of Vascular and Endovascular Surgery, Policlinico Di Monza, Monza, Italy., Odero A Jr; Istituto Auxologico Italiano, IRCCS, Department of Surgery, Milan, Italy., Malloggi C; Istituto Auxologico Italiano, IRCCS, Laboratory of Research in Vascular Surgery, Milan, Italy., Silani V; Istituto Auxologico Italiano, IRCCS, Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Ospedale San Luca, Milan, Italy.; Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, Milan, Italy., Parati G; Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milan, Italy.; Department of Medicine and Surgery, Università di Milano-Bicocca, Monza, Italy.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2020 Jul; Vol. 96 (1), pp. 129-135. Date of Electronic Publication: 2019 Aug 13.
DOI: 10.1002/ccd.28445
Abstrakt: Background: Patients with symptomatic carotid stenosis recently treated with percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS) are always classified as at high risk for surgery, given that they are required uninterrupted dual antiplatelet therapy. In this regard, carotid artery stenting (CAS) may represent a valid alternative.
Objective: The purpose of this study is to overview CAS outcomes in symptomatic patients with and without ACS.
Methods: One hundred fifty-one consecutive symptomatic patients who underwent CAS between 2010 and 2017 in a single institution were included in this study, of which 66 (43.7%) were identified as having ACS. All patients were followed-up with carotid duplex ultrasound scan and a neurological assessment of symptoms status at 30-day postprocedure and at 3, 6, and 12 months, with annual follow-up after that for 3 years.
Results: Among symptomatic ACS patients, common risks factors were active smoking, metabolic syndrome, diabetes, and hypertension. In the short-term follow-up, no significant differences were observed among rates of death, stroke, myocardial infarction (MI), and restenosis, between patients with and without ACS. Mean clinical follow-up was 28.2 (12.3) months. In the long-term follow-up, higher rates of death and MI were recorded in patients with ACS (death: 11.4% vs. 5.4%, p = .04; MI: 11.4% vs. 3.6%, p = .02), owing to the complexity of these patients.
Conclusions: This single-center study suggested that CAS is a safe and effective treatment for patients with symptomatic carotid artery stenosis, who recently underwent PTCA for ACS, requiring uninterrupted dual antiplatelet therapy.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz: