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Abstract 404: Secondary Prevention After Carotid Stenting in Patients with Atrial Fibrillation
Abstract   Open access   Peer reviewed

Abstract 404: Secondary Prevention After Carotid Stenting in Patients with Atrial Fibrillation

A Hanson and E Samaniego
Stroke: vascular and interventional neurology, Vol.4(S1)
11/01/2024
DOI: 10.1161/SVIN.04.suppl_1.404
PMCID: PMC12774227
url
https://doi.org/10.1161/SVIN.04.suppl_1.404View
Published (Version of record) Open Access

Abstract

IntroductionCardio‐embolism from atrial fibrillation and athero‐embolism for carotid stenosis account for ~45‐55% of all ischemic stroke and they often are present simultaneously, with some studies suggesting rates as high as 8.8‐9.3%. Stent‐assisted percutaneous transluminal angioplasty (SAPTA) is a common treatment for symptomatic or high‐grade stenosis. However, the best preventive regimen for patients who have undergone carotid stenting with previously diagnosed atrial fibrillation is still largely undetermined. The present study aims to determine the safest and most effective secondary stroke prevention in this patient population.MethodsWe conducted a single‐center retrospective study on patients with atrial fibrillation who underwent SAPTA. We compared the incidence of major bleeding events in the first three months post‐surgery across three groups: those on DAPT, those on an anticoagulant and an anti‐platelet, or DAPT and an anticoagulant (so called “triple therapy”) given in the first three months following the procedure. Secondary outcomes reviewed were strokes following the procedure, stent occlusion, non‐major bleeding events, and all‐cause mortality.ResultsMajor hemorrhagic events were observed in 3.2% of patients on DAPT, 5.3% of patients on DAPT and an anticoagulant, and 7.7% of patients on triple therapy. However, there was no significant difference between these groups (p=0.71). Regarding stroke occurrence after stenting, it was noted in 6.4% of patients on DAPT alone, 3.5% of patients on DAPT and an anticoagulant, and 1.9% of patients on triple therapy (p=0.57).ConclusionsOur data suggest that the risk of major bleeding events and the risk of recurrent strokes are the same across all three groups. There was an overall lower incidence of recurrent stroke among those treated with triple therapy. However, it was not statistically significant. This finding could suggest that while the risk of major hemorrhage is similar between all groups, there may be a lower risk of recurrent stroke in patients that receive triple therapy but may also confer a higher risk of major hemorrhage.
 Embolisms Stroke Anticoagulants Cardiac arrhythmia

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