Simultaneous carotid endarterectomy and carotid stenting for bilateral carotid stenosis / 中华普通外科杂志

ABSTRACT

Objective To evaluate the feasibility and safety of simultaneous carotid endarterectomy (CEA) and carotid stenting (CAS) for bilateral carotid stenosis.Methods From Jan 2012 to Aug 2014,8 patients underwent simultaneous CEA and CAS.The surgical plan was based on clinical features and imaging findings.CEA before CAS was done in 5 patients,CAS before CEA was done in 3 patients.One patient also underwent simultaneous coronary artery bypass grafting due to unstable angina.Results Operation success rate was 100％.Intraoperative carotid shunts,patches and embolic protection devices were used in all patients.One patient developed post-procedural hyperperfusion syndrome and returned to normal after symptomatic treatment.The remaining patients recovered uneventfully,there were no cerebrovascular accident,nerve injury or wound complications.Follow-up period was 18-48 months,follow-up rate was 100％.During the follow-up,all patients were relatively stable,no re-stenosis,death or cardiovascular events.Conclusions Through thorough evaluation,careful preparation,and strict management,simultaneous CEA and CAS is a technically feasible and safe treatment strategy for bilateral carotid stenosis.