Journal article
Secondary Prevention after Carotid Stenting in Patients With Atrial Fibrillation
Vascular and endovascular surgery, Vol.60(3), pp.201-208
04/2026
DOI: 10.1177/15385744251387547
PMID: 41100890
Abstract
Introduction
There is no consensus on the optimal secondary stroke prevention regimen for patients with atrial fibrillation undergoing carotid artery stenting (CAS). Our objective is to compare the long-term efficacy and safety of different medical regimens after CAS.
Methods
This retrospective observational study included patients with pre-existing atrial fibrillation who underwent CAS from 2011 to 2024. Patients were divided into three treatment groups: dual antiplatelet therapy (DAPT), single antiplatelet therapy plus oral anticoagulation (AA), and triple therapy (dual antiplatelet therapy plus oral anticoagulation, TT). The primary outcome was the incidence of major bleeding. Secondary outcomes included the incidence of clinically relevant minor bleeding, recurrent stroke, and stent thrombosis.
Results
Of the 1047 patients who underwent CAS, 129 met the inclusion criteria: 31 in the DAPT group, 46 in the AA group, and 52 in the TT group. At 3 months, major bleeding events occurred in 3.2% (1/31) of patients in the DAPT group, 6.5% (3/46) in the AA group, and 7.7% (4/52) in the TT group (P = 0.71). Ischemic stroke after stent placement occurred in 6.4% (2/31) of cases in the DAPT group, compared to 4.3% (2/46) in the AA group and 1.9% (1/52) in the TT group (P = 0.57). Stent thrombosis occurred in 3.2% (1/31) of patients in the DAPT group, 6.5% (3/46) in the AA group, and 1.9% (1/52) in the TT group (P = 0.32).
Conclusion
Our findings suggest no significant differences in bleeding events or ischemic outcomes among the different antiplatelet and anticoagulation regimens in patients with atrial fibrillation who underwent CAS.
Details
- Title: Subtitle
- Secondary Prevention after Carotid Stenting in Patients With Atrial Fibrillation
- Creators
- Alex D Hanson - University of IowaDiedo J Ojeda - University of ConnecticutArshaq Saleem - University of IowaElena Sagues - University of IowaAndres Gudino - University of IowaRandall Krug - University of IowaEdgar A Samaniego - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Vascular and endovascular surgery, Vol.60(3), pp.201-208
- DOI
- 10.1177/15385744251387547
- PMID
- 41100890
- NLM abbreviation
- Vasc Endovascular Surg
- ISSN
- 1938-9116
- eISSN
- 1938-9116
- Publisher
- SAGE PUBLICATIONS INC; THOUSAND OAKS
- Language
- English
- Electronic publication date
- 10/16/2025
- Date published
- 04/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985016011502771
Metrics
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