Journal of Vascular Surgery
Volume 47, Issue 6 , Pages 1227-1234 , June 2008

Staged bilateral carotid stenting, an effective strategy in high-risk patients – insights from a prospective multicenter trial

  • Nicolas Diehm, MD

      Affiliations

    • Baptist Cardiac and Vascular Institute, Miami, Fla
    • Swiss Cardiovascular Center, Division of Clinical and Interventional Angiology, Inselspital, University of Bern, Bern, Switzerland.
    • ,
  • Barry T. Katzen, MD

      Affiliations

    • Baptist Cardiac and Vascular Institute, Miami, Fla
    • Corresponding Author InformationCorrespondence: Barry T. Katzen, MD, Founder and Medical Director, Baptist Cardiac and Vascular Institute, 8900 North Kendall Drive, Miami, FL 33176.
    • ,
  • Sriram S. Iyer, MD

      Affiliations

    • Lenox Hill Hospital, New York, NY
    • ,
  • Christopher J. White, MD

      Affiliations

    • Ochsner Clinic Foundation, New Orleans, La
    • ,
  • L. Nelson Hopkins, MD

      Affiliations

    • University of Buffalo, Buffalo, NY
    • ,
  • Lynne Kelley, MD

      Affiliations

    • Boston Scientific Corporation, Natick, Mass
    • ,
  • BEACH investigators

Received 4 November 2007 ,Accepted 12 January 2008.

References 

  1. Barnett HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis (North American Symptomatic Carotid Endarterectomy Trial Collaborators). N Engl J Med. 1998;339:1415–1425
  2. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis (North American Symptomatic Carotid Endarterectomy Trial Collaborators). N Engl J Med. 1991;325:445–453
  3. Endarterectomy for asymptomatic carotid artery stenosis (Executive Committee for the Asymptomatic Carotid Atherosclerosis Study). JAMA. 1995;273:1421–1428
  4. Roffi M, Yadav JS. Carotid stenting. Circulation. 2006;114:1–4
  5. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–1501
  6. White CJ, Iyer SS, Hopkins LN, Katzen BT, Russell ME. Carotid stenting with distal protection in high surgical risk patients: the BEACH trial 30 day results. Catheter Cardiovasc Interv. 2006;67:503–512
  7. Iyer SS, White C, Hopkins LN, Katzen B, Safian R, Wholey M, et al. Carotid Artery Revascularization in High Surgical Risk Patients Using the Carotid WALLSTENT® and FilterWire EX®/EZ: 1-Year Outcomes in the BEACH Trial Pivotal Group. JACC. 2007;in press
  8. da Silva AF, McCollum P, Szymanska T, de Cossart L. Prospective study of carotid endarterectomy and contralateral carotid occlusion. Br J Surg. 1996;83:1370–1372
  9. Mathur A, Roubin GS, Iyer SS, Piamsonboon C, Liu MW, Gomez CR, et al. Predictors of stroke complicating carotid artery stenting. Circulation. 1998;97:1239–1245
  10. Roubin GS, New G, Iyer SS, Vitek JJ, Al-Mubarak N, Liu MW, et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation. 2001;103:532–537
  11. Chen MS, Bhatt DL, Mukherjee D, Chan AW, Roffi M, Kapadia SR, et al. Feasibility of simultaneous bilateral carotid artery stenting. Catheter Cardiovasc Interv. 2004;61:437–442
  12. Henry M, Gopalakrishnan L, Rajagopal S, Rath PC, Henry I, Hugel M. Bilateral carotid angioplasty and stenting. Catheter Cardiovasc Interv. 2005;64:275–282
  13. Stanziale SF, Wholey MH, Boules TN, Selzer F, Makaroun MS. Determining in-stent stenosis of carotid arteries by duplex ultrasound criteria. J Endovasc Ther. 2005;12:346–353
  14. Lal BK, Hobson RW, Goldstein J, Chakhtoura EY, Duran WN. Carotid artery stenting: is there a need to revise ultrasound velocity criteria?. J Vasc Surg. 2004;39:58–66
  15. Kaplan ML, Meier P. Nonparametric estimation from incomplete observations. J AM Stat Ass. 1958;457–481
  16. Counsell CE, Salinas R, Naylor R, Warlow CP. A systematic review of the randomised trials of carotid patch angioplasty in carotid endarterectomy. Eur J Vasc Endovasc Surg. 1997;13:345–354
  17. Gasecki AP, Eliasziw M, Ferguson GG, Hachinski V, Barnett HJ. Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion: results from NASCET. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. J Neurosurg. 1995;83:778–782
  18. Hofmann R, Niessner A, Kypta A, Steinwender C, Kammler J, Kerschner K, et al. Risk score for peri-interventional complications of carotid artery stenting. Stroke. 2006;37:2557–2561
  19. Farsak B, Oc M, Boke E. Simultaneous bilateral carotid endarterectomy: our first experience. Ann Thorac Cardiovasc Surg. 2001;7:292–296
  20. Young JR, Humphries AW, Beven EG, DeWolfe VG. Carotid endarterectomy without a shunt (Experiences using hyperbaric general anesthesia). Arch Surg. 1969;99:293–297
  21. Ketonen P, Luosto R, Mattila S, Nemes A, Ketonen L. Surgical experience with simultaneous bilateral carotid endarterectomies. Scand J Thorac Cardiovasc Surg. 1979;13:321–326
  22. Toung TJ, Sieber FE, Grayson RF, Derrer SA. Chemoreceptor injury as probable cause of respiratory depression after a simultaneous, bilateral carotid endarterectomy. Crit Care Med. 1990;18:1290–1291
  23. Darling RC, Kubaska S, Shah DM, Paty PS, Chang BB, Lloyd WE, et al. Bilateral carotid endarterectomy during the same hospital admission. Cardiovasc Surg. 1996;4:759–762
  24. Rodriguez-Lopez JA, Diethrich EB, Olsen DM. Postoperative morbidity of closely staged bilateral carotid endarterectomies: an intersurgical interval of 4 days or less. Ann Vasc Surg. 2001;15:457–464
  25. Habozit B, Derosier JP, Gaillard A. Risk of early controlateral carotid endarterectomy. Ann Vasc Surg. 1997;11:491–495
  26. Mathur A, Roubin GS, Yadav JS, Iyer SS, Vitek J. Combined coronary and bilateral carotid stenting: a case report. Cathet Cardiovasc Diagn. 1997;40:202–206
  27. Kiesz RS, Rozek MM, Bouknight D. Bilateral carotid stenting combined with three-vessel percutaneous coronary intervention in single setting. Catheter Cardiovasc Interv. 2001;52:100–104discussion 105
  28. Al-Mubarak N, Roubin GS, Vitek JJ, Gomez CR. Simultaneous bilateral carotid stenting for restenosis after endarterectomy. Cathet Cardiovasc Diagn. 1998;45:11–15
  29. Lesley WS, Lazo A, Kazmierczak CD, Wilseck JM. Simultaneous bilateral carotid stenting for postendarterectomy restenosis. Catheter Cardiovasc Interv. 2003;58:147–150
  30. Finsterer J, Strassegger J, Haymerle A, Hagmuller G. Bilateral stenting of symptomatic and asymptomatic internal carotid artery stenosis due to fibromuscular dysplasia. J Neurol Neurosurg Psychiatry. 2000;69:683–686
  31. Bali HK, Bhargava M, Bhatta YK, Sandhu MS. Single stage bilateral common carotid artery stenting in a patient of Takayasu arteritis. Neurol India. 2001;49:87–90
  32. Gray WA, Hopkins LN, Yadav S, Davis T, Wholey M, Atkinson R, et al. Protected carotid stenting in high-surgical-risk patients: the ARCHeR results. J Vasc Surg. 2006;44:258–268
  33. Ringleb PA, Allenberg J, Bruckmann H, Eckstein HH, Fraedrich G, Hartmann M, et al. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised noninferiority trial. Lancet. 2006;368:1239–1247
  34. Frericks H, Kievit J, van Baalen JM, van Bockel JH. Carotid recurrent stenosis and risk of ipsilateral stroke: a systematic review of the literature. Stroke. 1998;29:244–250
  35. Bernstein EF, Torem S, Dilley RB. Does carotid restenosis predict an increased risk of late symptoms, stroke, or death?. Ann Surg. 1990;212:629–636
  36. Groschel K, Riecker A, Schulz JB, Ernemann U, Kastrup A. Systematic review of early recurrent stenosis after carotid angioplasty and stenting. Stroke. 2005;36:367–373
  37. McCabe DJ, Pereira AC, Clifton A, Bland JM, Brown MM. Restenosis after carotid angioplasty, stenting, or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS). Stroke. 2005;36:281–286
  38. Meyers PM, Higashida RT, Phatouros CC, Malek AM, Lempert TE, Dowd CF, et al. Cerebral hyperperfusion syndrome after percutaneous transluminal stenting of the craniocervical arteries. Neurosurgery. 2000;47:335–343discussion 343-5
  39. Diehm N, Katzen B, Dick F, Kovacs M, Zemel G, Powell A, et al. Influence of stent type on hemodynamic depression after carotid artery stenting. J Vasc Interv Radiol (in press).

 The BEACH trial was supported by Boston Scientific Corporation.

 Competition of interest: Drs Iyer, Hopkins, and Katzen are consultants of Boston Scientific Corporation (BSC); Dr Kelley is former employee of BSC; Drs Iyer, Hopkins, and Katzen are stockholders of BSC; Drs Hopkins and Katzen receive educational grant support from BSC; Drs White and Diehm have no conflicts to report related to this trial.

PII: S0741-5214(08)00107-9

doi: 10.1016/j.jvs.2008.01.035

Journal of Vascular Surgery
Volume 47, Issue 6 , Pages 1227-1234 , June 2008

Article Tools

* Image Usage & Resolution