Carotid Stenting for Patients With Coexisting Carotid and Coronary Disease

Xavier, Andrew

doi:10.1001/archneurol.2008.508

Cited by 2 publications

(1 citation statement)

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“…Although the presence of CAD is one of the indications in choosing CAS for carotid revascularization [23], we found that it should be more precautious when performing CAS in patients with coexisting CAD since they may also have a higher risk for peri-CAS cerebral ischemic lesions comparing to those without coexisting CAD. However, the optimal pre-operation survey for CAD remains a debate in patients with ECAS.…”

Section: Discussionmentioning

confidence: 79%

Impact of Coexisting Coronary Artery Disease on the Occurrence of Cerebral Ischemic Lesions after Carotid Stenting

Huang

Chang

et al. 2014

PLoS ONE

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BackgroundCoronary artery disease (CAD) may coexist with extracranial carotid artery stenosis (ECAS), but the influence of CAD on procedure-related complications after carotid artery stenting (CAS) has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI) scanning.MethodsCoronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days.ResultsAmong 126 patients (69.5±9.0 years) recruited for unilateral protected CAS, 33 (26%) patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33) and 48% (45 in 93) of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6–10.0; P = .0018), and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (P = .0032). In patients with no CAD (n = 55), asymptomatic CAD (n = 41) and symptomatic CAD (n = 30), the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (P = .0048), and the peri-CAS stroke rates were 2%, 7% and 0% (P = .2120).ConclusionsThe severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.

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Section: Discussionmentioning

confidence: 79%