Abstract TP204: Frequency Of Coronary Artery Stenosis Greater Than 75% In Patients With Carotid Artery Stenosis Treated With Cas: Evaluation Using Coronaty Cta And Coronary Angiography

Abstract

Background and Purpose: Acute myocardial infarction(AMI) occurs in 1-2% of patients treated with carotid artery stenting(CAS), and is considered as one of the most serious perioperative complication. We assessed coronary artery stenosis in patients treated with CAS using coronary CTA or coronary angiography. Methods: Consecutive sixty-two patients (47 men, mean age 73.4 years) treated with CAS were examined by coronary CTA or angiography within 3 months before CAS between January 2010 and August 2012. In patients suspected coronary artery stenosis by coronary CTA, coronary angiography was performed. Significantly coronary artery stenosis was defined as that greater than 75%. Results: CAS was performed in 62 patients, and coronary artery was evaluated in 57 patients. Patients with allergic reaction for contrast agents, renal failure, and poor general condition were excluded from this study. Thirty-eight patients had significant coronary artery stenosis. Twenty-nine of them had any history of chest pain, and sixteen patients demonstrated normal ECG. Nine patients had PCI or CABG before admission and twenty-five patients were treated with PCI of CABG at the perioperative period of CAS. No patients had AMI at this period. Any characteristic changes were not found on carotid angiogram and coronary angiogram. However, patients with significant coronary artery stenosis were tend to have peripheral arterial disease (P=0.065) or intracranial artery stenosis (P=0.08) compared with those without coronary stenosis. Conclusions: 1. The rate of associated coronary artery stenosis in patients treated with CAS is much higher than that previously reported. 2. 70% patients had significant coronary artery stenosis and 40% needed treatment for coronary artery stenosis in our series. 3. Evaluation of coronary artery using CT angiography is effective to identify patients with high risk of AMI at the perioperative period of CAS.