Efficacy and safety of intensified antithrombotic therapy followed by stenting in treatment of highly severe stenosis accompanied by thrombosis in carotid atherosclerosis

Abstract

ObjectiveThis study explored the efficacy and safety of intensified antithrombotic therapy followed by stenting in treatment of highly severe stenosis accompanied by thrombosis in patients with carotid atherosclerosis (CAS). MethodsThis study recruited a total of 24 CAS patients between June 2016 and November 2020 in the research group, who had highly severe stenosis accompanied by in situ thrombosis and were treated with intensified antithrombotic treatment followed by stenting. The control group included 17 patients treated with stent angioplasty immediately after diagnosis with stenosis and thrombosis between January 2012 and May 2016. The efficacy and safety of treatment were compared between these two groups. ResultsThe thrombus completely disappeared in 22 out of 24 patients (91.67%) in the research group after intensified antithrombotic treatment followed by stenting. Two patients still had the thrombus, but the volume was significantly reduced compared to that pre-treatment. The incidence of clinical events and new infarctions in the research group was significantly lower than that in the control group. In addition, the research group had significantly lower incidence of embolus antedisplacement and blocking the emboshield during the operation than the control group. There were no significant differences in the incidence of long-term complications and mortality between these two groups. The clinical prognosis of patients in the research group was significantly better than that of those in the control group within 3 months after treatment. ConclusionIntensified antithrombotic therapy followed by stenting can effectively reduce the risk of perioperative complications in CAS patients with highly severe stenosis accompanied by thrombosis and improve the long-term clinical prognosis of patients without increasing the risk of bleeding.