SIMULTANEOUS BILATERAL CAROTID STENTING VS STAGED BILATERAL CAROTID STENTING : A RETROSPECTIVE CLINICAL INVESTIGATION

Abstract

Objective-: Simultaneous bilateral carotid artery stenting (SBCAS) is a complicated and challenging procedure. Final outcome depends upon selective criteria. The purpose of study was to determine the efcacy and safety of the SBCAS retrospectively patients with signicant bilateral carotid artery disease vs staged bilateral carotid stenting. Patients Method: with symptomatic stenosis of 50% or asymptomatic stenosis of 60% of bilateral carotid arteries are included for bilateral carotid artery stenting (BCAS). Procedure time, stent thrombosis,dissection,bradycardia ,hypotension,ischemia, presence of high-intensity spots on postoperative dwi image, duration of postprocedure stays and one month outcome of patients performed with simultaneous BCAS (group A, 11 patients with 22 stenotic lesions (11 procedures)) were compared with those of staged BCAS (group B, 14 patients with 28 stenotic lesions (28 procedures))out of total 205 patients during march 2017 to January 2021. In Results: groups A and B, median procedure time was 166.0 and 115 min; intraprocedure hypotension was observed in 52% and 40%; postprocedure hypotension occurred in 40% and 42%; dwi image showed high intensity spots in 25% and 12.5%; and median duration of postprocedural hospital stays was 5.1 and 6.3 days.One patient suffered ischemic complications and recoverd. Procedure time was longer in simultaneous BCAS, but there was no increase in symptomatic ischemic complications and duration of hospital stays compared to staged BCAS. Safety of Conclusions: simultaneous BCAS may be noninferior to staged BCAS. In terms of cost and duration of hospitalization,simultaneous BCAS are often superior to staged BCAS for patients with bilateral carotid artery stenosis