Safety of Simultaneous Bilateral Internal Carotid Artery Stenting

Background : Stroke is a major global cause of death, affecting nearly 13.7 million people annually. Carotid artery stenosis accounts for up to 12% of all ischemic strokes. Bilateral carotid stenosis, which affects between 8% and 39% of patients with symptomatic carotid stenosis, presents a treatment challenge, as it is often a relative contraindication for carotid endarterectomy and is excluded from many clinical trials. With advancements in endovascular technology, simultaneous bilateral carotid angioplasty and stenting (SBCAS) has emerged as a safe and effective option, with complication risks similar to those of unilateral carotid artery stenting. The safety profile of SBCAS has been the subject of various studies, which have reported mixed outcomes. Results : The study included twenty patients; 14 males (70%) and 6 females (30%). The age of the patients ranged from 51 to 75 years with a mean age of 63.95 ± 6.79. Fourteen cases (70%) had ischemic stroke and 6 cases (30%) presented with TIA. Site of stenosis was mainly in the proximal internal carotid artery (70.0% of cases in right side) and (85.0% in left side), while Degree of stenosis showed that 50.0% had more than 70 % stenosis on the right ICA while 70.0% had more than 70 % stenosis in the left side. Timing of intervention was (in minutes) 60.50 ± 7.76; Types of stents in those twenty patients (forty carotid stents, two for each patient) 62.5 % were wall stents, 12.5% were Portege and 25 % were CASPER stent. Forty percent (40%) had hemodynamic depression, 5% had hyper perfusion syndrome. Neither Vascular access complications, Stroke, Cardiac complications or Mortality were reported in our study group. There were no mortality, stroke or Cardiac complications after one month follow up. Conclusion : SBCAS is a safe and effective procedure for properly selected patients with bilateral carotid stenosis and can help reduce the risk of recurrent cerebrovascular events.