Surgical treatment of bilateral carotid artery stenosis

Abstract

Objective To evaluate carotid endarterectomy (CEA) and carotid artery stenting (CAS)for the treatment of bilateral severe carotid artery stenosis. Methods This retrospective study included 21 patients of bilateral carotid stenosis undergoing bilateral CEA or joint CEA and CAS in our department from August 2012 to June 2015.Of these patients, 20 underwent symptom side CEA, 1 with bilateral asymptomatic stenosis underwent CEA on less severe side, contralateral carotid artery plaque was removed after 2 to 4 weeks. Results 21 patients underwent a total of 42 consecutive procedures successfully (39 CEAs, 3CASs). Postoperatively symptoms in 18 cases (90.5%) disappeared or significantly relieved. 3 cases (9.5%) suffered after treatment hyperperfusion syndrome. All 21 patients were followed up and recovered. Conclusion For patients with bilateral carotid stenosis, bilateral carotid revascularization is particularly necessary. Appropriately arranged stage reconstruction significantly reduces postoperative hyperperfusion. Key words: Carotid stenosis; Endarterectomy, carotid; Stenting