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1. Discovering the Italian phenotype of cerebral amyloid angiopathy (CAA): the SENECA project

Author

Bersano, A, Scelzo, E, Pantoni, L, Morotti, A, Erbetta, A, Chiapparini, L, Vitali, P, Giaccone, G, Caroppo, P, Catania, M, Obici, L, Di Fede, G, Gatti, L, Tinelli, F, Di Francesco, J, Piazza, F, Ferrarese, C, Gasparini, M, Adobbati, L, Bianchi-Marzoli, S, Tremolada, G, Sacco, S, Mancuso, M, Zedde, M, Godani, M, Lanfranconi, S, Pareyson, D, Di Girolamo, M, Motto, C, Charidimou, A, Boulouis, G, Parati, E, Bersano, Anna, Scelzo, Emma, Pantoni, Leonardo, Morotti, Andrea, Erbetta, Alessandra, Chiapparini, Luisa, Vitali, Paolo, Giaccone, Giorgio, Caroppo, Paola, Catania, Marcella, Obici, Laura, Di Fede, Giuseppe, Gatti, Laura, Tinelli, Francesca, Di Francesco, Jacopo C., Piazza, Fabrizio, Ferrarese, Carlo, Gasparini, Massimo, Adobbati, Laura, Bianchi-Marzoli, Stefania, Tremolada, Gemma, Sacco, Simona, Mancuso, Michelangelo, Zedde, Maria Luisa, Godani, Massimiliano, Lanfranconi, Silvia, Pareyson, Davide, Di Girolamo, Marco, Motto, Cristina, Charidimou, Andreas, Boulouis, Gregoire, Parati, Eugenio A., Bersano, A, Scelzo, E, Pantoni, L, Morotti, A, Erbetta, A, Chiapparini, L, Vitali, P, Giaccone, G, Caroppo, P, Catania, M, Obici, L, Di Fede, G, Gatti, L, Tinelli, F, Di Francesco, J, Piazza, F, Ferrarese, C, Gasparini, M, Adobbati, L, Bianchi-Marzoli, S, Tremolada, G, Sacco, S, Mancuso, M, Zedde, M, Godani, M, Lanfranconi, S, Pareyson, D, Di Girolamo, M, Motto, C, Charidimou, A, Boulouis, G, Parati, E, Bersano, Anna, Scelzo, Emma, Pantoni, Leonardo, Morotti, Andrea, Erbetta, Alessandra, Chiapparini, Luisa, Vitali, Paolo, Giaccone, Giorgio, Caroppo, Paola, Catania, Marcella, Obici, Laura, Di Fede, Giuseppe, Gatti, Laura, Tinelli, Francesca, Di Francesco, Jacopo C., Piazza, Fabrizio, Ferrarese, Carlo, Gasparini, Massimo, Adobbati, Laura, Bianchi-Marzoli, Stefania, Tremolada, Gemma, Sacco, Simona, Mancuso, Michelangelo, Zedde, Maria Luisa, Godani, Massimiliano, Lanfranconi, Silvia, Pareyson, Davide, Di Girolamo, Marco, Motto, Cristina, Charidimou, Andreas, Boulouis, Gregoire, and Parati, Eugenio A.

Abstract

Cerebral amyloid angiopathy (CAA) is one of the major types of cerebral small vessel disease, and a leading cause of spontaneous intracerebral hemorrhage and cognitive decline in elderly patients. Although increasingly detected, a number of aspects including the pathophysiology, the clinical and neuroradiological phenotype, and the disease course are still under investigation. The incomplete knowledge of the disease limits the implementation of evidence-based guidelines on patient’s clinical management and the development of treatments able to prevent or reduce disease progression. The SENECA (SEarchiNg biomarkErs of Cerebral Angiopathy) project is the first Italian multicenter cohort study aimed at better defining the disease natural history and identifying clinical and neuroradiological markers of disease progression. By a multidisciplinary approach and the collection of a large and well-phenotyped series and biorepository of CAA patients, the study is ultimately expected to improve the diagnosis and the knowledge of CAA pathophysiological mechanisms.

Published
2020

2. The role of clinical and neuroimaging features in the diagnosis of CADASIL

Author

Bersano, A, Bedini, G, Markus, H, Vitali, P, Colli-Tibaldi, E, Taroni, F, Gellera, C, Baratta, S, Mosca, L, Carrera, P, Ferrari, M, Cereda, C, Grieco, G, Lanfranconi, S, Mazucchelli, F, Zarcone, D, De Lodovici, M, Bono, G, Boncoraglio, G, Parati, E, Calloni, M, Perrone, P, Bordo, B, Motto, C, Agostoni, E, Pezzini, A, Padovani, A, Micieli, G, Cavallini, A, Molini, G, Sasanelli, F, Sessa, M, Comi, G, Checcarelli, N, Carmerlingo, M, Corato, M, Marcheselli, S, Fusi, L, Grampa, G, Uccellini, D, Beretta, S, Ferrarese, C, Incorvaia, B, Tadeo, C, Adobbati, L, Silani, V, Faragò, G, Trobia, N, Grond-Ginsbach, C, Candelise, L, Mazzucchelli, F, Guidotti, M, Riva, M, Iurlaro, S, Maria, B, Braga, M, Meola, G, Carpo, M, Camerlingo, M, Borutti, G, Delodovici, M, Verrengia, E, Tancredi, L, Terruzzi, A, Magoni, M, Del Zotto, E, Bassi, P, Lattuada, P, Ballabio, E, Gambaro, P, Corrà, B, Canavero, I, Arbustini, E, Grasso, M, Corti, S, Ronchi, D, Merlini, G, Obici, L, Bassi, M, Tagliavini, F, Ginsbach, C, Bersano, Anna, BEDINI, GLORIA, Markus, Hugh Stephen, Vitali, Paolo, Colli-Tibaldi, Enrico, Taroni, Franco, Gellera, Cinzia, Baratta, Silvia, Mosca, Lorena, Carrera, Paola, FERRARI, MAURIZIO, Cereda, Cristina, Grieco, Gaetano, Lanfranconi, Silvia, Mazucchelli, Franca, Zarcone, Davide, De Lodovici, Maria Luisa, Bono, Giorgio, Boncoraglio, Giorgio Battista, Parati, Eugenio Agostino, Calloni, Maria Vittoria, Perrone, Patrizia, Bordo, Bianca Maria, Motto, Cristina, Agostoni, Elio, Pezzini, Alessandro, Padovani, Alessandro, Micieli, Giuseppe, Cavallini, Anna, Molini, Graziella, Sasanelli, Francesco, Sessa, Maria, Comi, Giancarlo, Checcarelli, Nicoletta, Carmerlingo, Massimo, CORATO, MANUEL, Marcheselli, Simona, Fusi, Laura, Grampa, Giampiero, Uccellini, Davide, Beretta, Simone, Ferrarese, Carlo, Incorvaia, Barbara, Tadeo, Carlo Sebastiano, Adobbati, Laura, Silani, Vincenzo, Faragò, Giuseppe, Trobia, Nadia, Grond-Ginsbach, Caspar, Candelise, Livia, Mazzucchelli, Franca, Guidotti, Mario, Riva, Maurizio, Iurlaro, Simona, Maria, Bianca Bordo, Braga, Massimiliano, Meola, Giovanni, Carpo, Marinella, Camerlingo, Massimo, Borutti, Giuseppina, Delodovici, Marialuisa, Verrengia, Elena Pinuccia, Tancredi, Lucia, Terruzzi, Alessandro, Magoni, Mauro, Del Zotto, Elisabetta, Bassi, Pietro, Lattuada, Patrizia, Ballabio, Elena, Gambaro, Paola, Lanfranconi, Sivia, Corrà, Barbara, Canavero, Isabella, Arbustini, Eloisa, Grasso, Maurizia, Comi, Giacomo Pietro, Corti, Stefania, Ronchi, Dario, Merlini, Giampaolo, Obici, Laura, Bassi, Maria Teresa, Tagliavini, Fabrizio, Ginsbach, Caspar Grond, Bersano, A, Bedini, G, Markus, H, Vitali, P, Colli-Tibaldi, E, Taroni, F, Gellera, C, Baratta, S, Mosca, L, Carrera, P, Ferrari, M, Cereda, C, Grieco, G, Lanfranconi, S, Mazucchelli, F, Zarcone, D, De Lodovici, M, Bono, G, Boncoraglio, G, Parati, E, Calloni, M, Perrone, P, Bordo, B, Motto, C, Agostoni, E, Pezzini, A, Padovani, A, Micieli, G, Cavallini, A, Molini, G, Sasanelli, F, Sessa, M, Comi, G, Checcarelli, N, Carmerlingo, M, Corato, M, Marcheselli, S, Fusi, L, Grampa, G, Uccellini, D, Beretta, S, Ferrarese, C, Incorvaia, B, Tadeo, C, Adobbati, L, Silani, V, Faragò, G, Trobia, N, Grond-Ginsbach, C, Candelise, L, Mazzucchelli, F, Guidotti, M, Riva, M, Iurlaro, S, Maria, B, Braga, M, Meola, G, Carpo, M, Camerlingo, M, Borutti, G, Delodovici, M, Verrengia, E, Tancredi, L, Terruzzi, A, Magoni, M, Del Zotto, E, Bassi, P, Lattuada, P, Ballabio, E, Gambaro, P, Corrà, B, Canavero, I, Arbustini, E, Grasso, M, Corti, S, Ronchi, D, Merlini, G, Obici, L, Bassi, M, Tagliavini, F, Ginsbach, C, Bersano, Anna, BEDINI, GLORIA, Markus, Hugh Stephen, Vitali, Paolo, Colli-Tibaldi, Enrico, Taroni, Franco, Gellera, Cinzia, Baratta, Silvia, Mosca, Lorena, Carrera, Paola, FERRARI, MAURIZIO, Cereda, Cristina, Grieco, Gaetano, Lanfranconi, Silvia, Mazucchelli, Franca, Zarcone, Davide, De Lodovici, Maria Luisa, Bono, Giorgio, Boncoraglio, Giorgio Battista, Parati, Eugenio Agostino, Calloni, Maria Vittoria, Perrone, Patrizia, Bordo, Bianca Maria, Motto, Cristina, Agostoni, Elio, Pezzini, Alessandro, Padovani, Alessandro, Micieli, Giuseppe, Cavallini, Anna, Molini, Graziella, Sasanelli, Francesco, Sessa, Maria, Comi, Giancarlo, Checcarelli, Nicoletta, Carmerlingo, Massimo, CORATO, MANUEL, Marcheselli, Simona, Fusi, Laura, Grampa, Giampiero, Uccellini, Davide, Beretta, Simone, Ferrarese, Carlo, Incorvaia, Barbara, Tadeo, Carlo Sebastiano, Adobbati, Laura, Silani, Vincenzo, Faragò, Giuseppe, Trobia, Nadia, Grond-Ginsbach, Caspar, Candelise, Livia, Mazzucchelli, Franca, Guidotti, Mario, Riva, Maurizio, Iurlaro, Simona, Maria, Bianca Bordo, Braga, Massimiliano, Meola, Giovanni, Carpo, Marinella, Camerlingo, Massimo, Borutti, Giuseppina, Delodovici, Marialuisa, Verrengia, Elena Pinuccia, Tancredi, Lucia, Terruzzi, Alessandro, Magoni, Mauro, Del Zotto, Elisabetta, Bassi, Pietro, Lattuada, Patrizia, Ballabio, Elena, Gambaro, Paola, Lanfranconi, Sivia, Corrà, Barbara, Canavero, Isabella, Arbustini, Eloisa, Grasso, Maurizia, Comi, Giacomo Pietro, Corti, Stefania, Ronchi, Dario, Merlini, Giampaolo, Obici, Laura, Bassi, Maria Teresa, Tagliavini, Fabrizio, and Ginsbach, Caspar Grond

Abstract

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial cerebral small vessel disease, caused by NOTCH3 gene mutations. The aim of our study was to identify clinical and neuroradiological features which would be useful in identifying which patients presenting with lacunar stroke and TIA are likely to have CADASIL. Methods: Patients with lacunar stroke or TIA were included in the present study. For each patient, demographic and clinical data were collected. MRI images were centrally analysed for the presence of lacunar infarcts, microbleeds, temporal lobe involvement, global atrophy and white matter hyperintensities. Results: 128 patients (mean age 56.3 ± 12.4 years) were included. A NOTCH3 mutation was found in 12.5% of them. A family history of stroke, the presence of dementia and external capsule lesions on MRI were the only features significantly associated with the diagnosis of CADASIL. Although thalamic, temporal pole gliosis and severe white matter hyperintensities were less specific for CADASIL diagnosis, the combination of a number of these factors together with familial history for stroke result in a higher positive predictive value and specificity. Conclusions: A careful familial history collection and neuroradiological assessment can identify patients in whom NOTCH3 genetic testing has a higher yield.

Published
2018

3. Impact of obstructive sleep apnea on cardiac organ damage in patients with acute ischemic stroke

Author

Mattaliano, P, Lombardi, C, Sangalli, D, Faini, A, Corrà, B, Adobbati, L, Branzi, G, Mariani, D, Silani, V, Parati, G, Mattaliano, Paola, Lombardi, Carolina, Sangalli, Davide, Faini, Andrea, Corrà, Barbara, Adobbati, Laura, Branzi, Giovanna, Mariani, Davide, Silani, Vincenzo, Parati, Gianfranco, Mattaliano, P, Lombardi, C, Sangalli, D, Faini, A, Corrà, B, Adobbati, L, Branzi, G, Mariani, D, Silani, V, Parati, G, Mattaliano, Paola, Lombardi, Carolina, Sangalli, Davide, Faini, Andrea, Corrà, Barbara, Adobbati, Laura, Branzi, Giovanna, Mariani, Davide, Silani, Vincenzo, and Parati, Gianfranco

Abstract

Background and purpose: Both obstructive sleep apnea (OSA) and cardiac organ damage have a crucial role in acute ischemic stroke. Our aim is to explore the relationship between OSA and cardiac organ damage in acute stroke patients. Methods: A total of 130 consecutive patients with acute ischemic stroke were enrolled. Patients underwent full multichannel 24-h polysomnography for evaluation of OSA and echocardiography to evaluate left ventricle (LV) mass index (LV mass/BSA, LV mass/height 2.7), thickness of interventricular septum (IVS) and posterior wall (LVPW), LV ejection fraction and left atrium enlargement. Information on occurrence of arterial hypertension and its treatment before stroke was obtained from patients' history. Results: 61.9% (70) of patients, mostly men (67.1%), with acute stroke had OSA (AHI > 10). Patients with acute stroke and OSA showed a significant increase (P < 0.05) of LV mass index, IVS and LVPW thickness and a significant left atrial enlargement as compared with patients without OSA. LV ejection fraction was not significantly different in stroke patients with and without OSA and was within normal limits. No relationship was found among cardiac alterations, occurrence of OSA and history of hypertension. Conclusion: Acute stroke patients with OSA had higher LV mass and showed greater left atrial enlargement than patients without OSA. This study confirms the high prevalence of OSA in stroke patients, suggesting also an association between OSA and cardiac target organ damage. Our finding of structural LV abnormalities in acute stroke patients with OSA suggests a potential role of OSA as contributing factor in determining both cerebrovascular and cardiac damage, even in absence of clear link with a history of blood pressure elevation.

Published
2018

4. Clinical factors associated with statins prescription in acute ischemic stroke patients: Findings from the Lombardia Stroke Registry

Author

Canavero, I, Cavallini, A, Perrone, P, Magoni, M, Sacchi, L, Quaglini, S, Lanzola, G, Micieli, G, Adobbati, L, Silani, V, Agostoni, E, Scaccabarozzi, C, Arnaboldi, M, Vidale, S, Baietti, G, Bettoni, L, Balducci, U, Chia, F, Baron, P, Bresolin, N, Bassi, P, Bazzi, P, Crespi, V, Beretta, S, Ferrarese, C, Bet, L, Meola, G, Bezzi, G, Boncoraglio, G, Parati, E, Bono, G, Delodovici, M, Bordo, B, Colombo, A, Borutti, G, Piccolo, G, Brusaferri, F, Prelle, A, Calloni, M, Camerlingo, M, Censori, B, Cerini, C, Turla, M, Checcarelli, N, Guidotti, M, Comi, G, Sessa, M, Costa, A, Donati, E, Ferrante, C, Frediani, F, Lattuada, P, Poloni, E, Gambaro, P, Mariani, C, Gomitoni, A, Grampa, G, Lanza, E, Magnoni, A, Marcheselli, S, Marsile, C, Molini, G, Sasanelli, F, Martignoni, A, Mattioli, M, Neromante, I, Porazzi, D, Poloni, M, Previdi, P, Silvestrelli, G, Riva, M, Zilioli, A, Romorini, A, Santilli, I, Tadeo, C, Zaccone, M, Zarcone, D, Zarcone, D., FERRARESE, CARLO, Canavero, I, Cavallini, A, Perrone, P, Magoni, M, Sacchi, L, Quaglini, S, Lanzola, G, Micieli, G, Adobbati, L, Silani, V, Agostoni, E, Scaccabarozzi, C, Arnaboldi, M, Vidale, S, Baietti, G, Bettoni, L, Balducci, U, Chia, F, Baron, P, Bresolin, N, Bassi, P, Bazzi, P, Crespi, V, Beretta, S, Ferrarese, C, Bet, L, Meola, G, Bezzi, G, Boncoraglio, G, Parati, E, Bono, G, Delodovici, M, Bordo, B, Colombo, A, Borutti, G, Piccolo, G, Brusaferri, F, Prelle, A, Calloni, M, Camerlingo, M, Censori, B, Cerini, C, Turla, M, Checcarelli, N, Guidotti, M, Comi, G, Sessa, M, Costa, A, Donati, E, Ferrante, C, Frediani, F, Lattuada, P, Poloni, E, Gambaro, P, Mariani, C, Gomitoni, A, Grampa, G, Lanza, E, Magnoni, A, Marcheselli, S, Marsile, C, Molini, G, Sasanelli, F, Martignoni, A, Mattioli, M, Neromante, I, Porazzi, D, Poloni, M, Previdi, P, Silvestrelli, G, Riva, M, Zilioli, A, Romorini, A, Santilli, I, Tadeo, C, Zaccone, M, Zarcone, D, Zarcone, D., and FERRARESE, CARLO

Abstract

Background: Statins, due to their well-established pleiotropic effects, have noteworthy benefits in stroke prevention. Despite this, a significant proportion of high-risk patients still do not receive the recommended therapeutic regimens, and many others discontinue treatment after being started on them. The causes of non-adherence to current guidelines are multifactorial, and depend on both physicians and patients. The aim of this study is to identify the factors influencing statin prescription at Stroke Unit (SU) discharge.Methods: This study included 12,750 patients enrolled on the web-based Lombardia Stroke Registry (LRS) from July 2009 to April 2012 and discharged alive, with a diagnosis of ischemic stroke or transient ischemic attack (TIA) and without contra-indication to statin therapy. By logistic regression analysis and classification trees, we evaluated the impact of demographic data, risk factors, tPA treatment, in-hospital procedures and complications on statin prescription rate at discharge.Results: We observed a slight increase in statins prescription during the study period (from 39.1 to 43.9%). Lower age, lower stroke severity and prestroke disability, the presence of atherothrombotic/lacunar risk factors, a diagnosis of non-cardioembolic stroke, tPA treatment, the absence of in-hospital complications, with the sole exception of hypertensive fits and hyperglycemia, were the patient-related predictors of adherence to guidelines by physicians. Overall, dyslipidemia appears as the leading factor, while TOAST classification does not reach statistical significance.Conclusions: In our region, Lombardia, adherence to guidelines in statin prescription at Stroke Unit discharge is very different from international goals. The presence of dyslipidemia remains the main factor influencing statin prescription, while the presence of well-defined atherosclerotic etiopathogenesis of stroke does not enhance statin prescription. Some uncertainties about the risk/benefit

Published
2014

5. The THRombolysis and STatins (THRaST) study

Author

Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., BERETTA, SIMONE, Cappellari, M, Bovi, P, Moretto, G, Zini, A, Nencini, P, Sessa, M, Furlan, M, Pezzini, A, Orlandi, G, Paciaroni, M, Tassinari, T, Procaccianti, G, Di Lazzaro, V, Bettoni, L, Gandolfo, C, Silvestrelli, G, Rasura, M, Martini, G, Melis, M, Calloni, M, Chiodo Grandi, F, Beretta, S, Guarino, M, Altavista, M, Marcheselli, S, Galletti, G, Adobbati, L, Del Sette, M, Mancini, A, Orrico, D, Monaco, S, Cavallini, A, Sciolla, R, Federico, F, Scoditti, U, Brusaferri, F, Grassa, C, Specchio, L, Bongioanni, M, Sparaco, M, Zampolini, M, Greco, G, Colombo, R, Passarella, B, Adami, A, Consoli, D, Toni, D, Toni, D., and BERETTA, SIMONE

Abstract

Objective: To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis. Methods: Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death. Results: Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007). Conclusion: Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome. © 2013 American Academy of Neurology.

Published
2013

6. Carotid artery stenting in patients with acute coronary syndrome: a possible primary therapy for symptomatic carotid stenosis

Author

Casana, R, Halliday, A, Bianchi, P, Fresa, E, Silani, V, Parati, G, Blengino, S, Cireni, L, Adobbati, L, Calvillo, L, Tolva, V, PARATI, GIANFRANCO, TOLVA, VALERIO STEFANO, Casana, R, Halliday, A, Bianchi, P, Fresa, E, Silani, V, Parati, G, Blengino, S, Cireni, L, Adobbati, L, Calvillo, L, Tolva, V, PARATI, GIANFRANCO, and TOLVA, VALERIO STEFANO

Abstract

Purpose: To report the results of carotid artery stenting (CAS) in symptomatic patients (stroke/transient ischemic attack) after recent percutaneous transluminal coronary angioplasty (PTCA) for acute coronary syndrome (ACS). Methods: Between January 2009 and July 2011, 28 consecutive patients (18 women; mean age 66 years, range 42-82) underwent protected CAS for symptomatic carotid stenosis following recent PTCA that included bare or drug-eluting stents requiring uninterrupted dual antiplatelet therapy. Primary technical success, neurological complications, major adverse cardiovascular events, and death were evaluated at 30 days and over midterm follow-up. Results: Technical success was 96%; 1 patient suffered a nonfatal major stroke (3.5% 30-day stroke rate) during the procedure. During a median 21.6-month follow-up, 4 (14%) patients died of myocardial infarction (all diabetic smokers with ejection fractions <40%), but there were no new neurological events. Estimated survival was 89.3% at 2 years. Further coronary interventions were performed in 2 diabetic patients with a body mass index >34 kg/m(2). Conclusion: This preliminary experience demonstrated that CAS is a reasonable, safe, and effective treatment for patients with symptomatic carotid artery stenosis who were recently treated with coronary stents requiring uninterrupted dual antiplatelet therapy

Published
2013

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