Szymon Oledzki, Jarosaw Goracy, Maciej Lewandowski, Katarzyna Widecka-Ostrowska, Andrzej Modrzejewski, Zdzisawa Kornacewicz-Jach
Background: Carotid artery stenosis occurs in 8–13% of patients with degenerative aortic stenosis. The risk of new postoperative stroke after cardiac surgery is thought to be two- to four-fold higher in patients with concomitant carotid stenosis. We evaluated the results of carotid stenting in patients with aortic valve stenosis.
Methods: We retrospectively analysed internal database containing patients after carotid artery stenting and identified patients with severe aortic valve stenosis. Then we evaluated the number of major complications in 30 days’ follow-up.
Results: Overall, 246 CAS procedures were performed among which the complications rate was 2.0% (3 deaths, 1 NSTEMI, 1 stroke). 14 of the procedures were conducted in patients with aortic valve stenosis. There were two (14.29%) procedural-related deaths. There were no neurological events and no instances of myocardial infarction. Both deaths occurred after the second CAS procedure in female patients. The correlation between death and the second CAS procedure was at the margin of significance (p=0.05). There were no other significant covariates associated with incidence of death (age p=0.63; female sex p=0.375; coronary artery disease p=0.63; diabetes mellitus p=0.3; hypercholesterolemia p=0.76; congestive heart failure p=0.45; previous ischemic stroke or TIA p=0.7; double vessel stenosis p=0.65; occlusion of contralateral internal carotid artery p=0.76; aortic valve area p=0.85).
Conclusion: The results imply that patients with aortic stenosis are at high risk of carotid revascularization. It should be emphasized that deaths occurred after the second CAS. Thus, it is possible that such patients are at the highest risk of periprocedural death.