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Double Carotid Artery Procedures Can Be Safe

Placing stents in both arteries at once won't significantly increase risk, study says

FRIDAY, March 4, 2005 (HealthDay News) -- In patients at high risk for stroke due to a narrowing of the carotid arteries that supply blood to the brain, doctors often resort to placing a stent -- a flexible tube -- within the artery, to help prop it open.

Two separate carotid arteries supply each side of the brain, but doctors have been hesitant to perform simultaneous stenting in patients with blockages in both arteries, worrying about patient safety. Instead they usually operate on one artery, then the other later on.

Now, a French study suggests it's safe and effective to perform simultaneous carotid stenting.

"Risks are no higher with simultaneous carotid angioplasty and stenting than with two-stage endovascular procedures, or surgery, in high-risk patients. This technique could be proposed to patients who are at high-risk for surgery and require rapid treatment," interventional cardiologist Dr. Michel Henry, Cabinet de Cardiologie in Nancy, said in a prepared statement.

Henry's team analyzed the medical records of 57 high-risk patients with severe narrowing of both carotid arteries. Seventeen of the patients had stenting on both carotid arteries in a single procedure and 10 had two procedures performed within 24 hours. The remaining patients had the second stenting procedure anywhere from two days to two months after the first operation.

Overall, four of the 57 patients suffered neurological complications such as stroke, cerebral hyperfusion and temporary stroke-like symptoms within 30 days of the procedure. One of these patients was in the simultaneous treatment group.

Two of the 57 patients died. Both of them were in the simultaneous treatment group.

The study found that 11.7 percent of the patients who had the simultaneous procedure suffered heart attack, stroke or death, compared to 7.4 percent of the patients who had a two-stage procedure.

Even though those risks were slightly higher among patients receiving simultaneous procedures, Henry stressed that, sometimes, waiting can be dangerous.

"Staged procedures delay definitive treatment of carotid lesions and could potentially put off life-saving procedures," he explained. "Some patients require a rapid treatment."

The study appears in the March issue of the journal Catheterization and Cardiovascular Interventions.

More information

The Society for Vascular Surgery has more about carotid stenting.

SOURCE: Society for Cardiovascular Angiography and Interventions, news release, Feb. 28, 2005
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