This study states that Tandem carotid artery lesions that involve simultaneous internal carotid artery (ICA) and common carotid artery (CCA) stenoses present a complex clinical problem. The addition of a retrograde proximal intervention to treat a CCA lesion during a carotid endarterectomy increases the risk of stroke and death. However, the stroke and death risk associated with totally endovascular treatment of tandem lesions is unknown and is the subject of this study.
Vascular Study Group of New England data for the years 2005 to 2020 were queried for carotid artery stenting (CAS) procedures. Emergent and bilateral procedures, procedures for indications other than atherosclerosis, patients with prior ipsilateral CAS, ICA lesions with stenosis <50%, and transcarotid procedures were excluded. The cohort was divided into tandem and isolated lesion groups. The primary outcome was the composite of any perioperative neurologic events (stroke and transient ischemic attack) and death. Predictors of stroke/death were determined with multivariable logistic regression.
There were 2016 carotid arteries stented in 1950 patients, 1881 (96%) with isolated lesions and 135 (4%) with tandem lesions. Mean age was 69.6 ± 9.0 years. Tandem lesions were more likely to be present in women.
Reference link- https://www.jvascsurg.org/article/S0741-5214(20)31436-1/fulltext
