Results of Transcatheter Treatment of Patients with Atherosclerotic Lesions of the Coronary and Carotid Arteries

Karen Petrosian ¹, Leo Bockeria ¹, Bagrat Alekyan ², Karen Petrosian ¹, Yuri Buziashvili ¹, Olga Bockeria ¹, Badri Makhaldiani ¹

¹ A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia; ² A.V. Vishnevsky Institute of Surgery, Moscow, Russia;

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – A

Abstract

Purpose ofstudy:The purpose this study is to evaluate the effectiveness\efficiency of endovascular treatment of patients with comorbid cardiac pathology and atherosclerotic lesion (AL) of the internal carotid artery.Material and method of study.Patients (n-75), with AL of the internal carotid and coronary arteries, operated from 2009 to 2017 were included in the study. The first group included the patients (n-38) who underwent carotid stenting followed by percutaneous coronary intervention.In the second study group (n-37), on the patients who had undergone carotid stenting, the aortocoronary bypass surgery was performed.  In 3 (3.9%) patients of the first group, aneurysmal dilatation of the internal carotid artery after carotid endarterectomy (CEAE) was observed. In one patient 3 weeks after carotid stenting, correction of valvular pathology was performed. In 100% of cases with carotid stenting, means of protection\prevention from distal embolism was employed. Post-operative and distant (from 6 months) observation period was evaluated at primary endpoints (stroke / myocardial infarction / death).Results.In the study groups of patients, angiographic and technical success with endovascular intervention reached 100%. In the post-operative observation period in the first group, a small stroke occurred in 1 (2.6%) of the patients who underwent carotid stenting.No infarctions and / or deaths in the long-term follow-up period. In the second group, in the post-operative and long-term follow-up periods, one (2.7%) patient died after a prosthetic aortic valve from acute heart failure with multi-organ failure, in the long-term follow-up no complications at primary endpoints were observed.Conclusion

Stenting of the internal carotid artery in patients with comorbid cardiac pathology is a highly effective and relatively safe method of treatment. The choice steps implemented and degree of intervention in each specific case is determined individually, and depends both on the experience of the surgeon performing the procedure and on the clinic where such intervention is performed