Comparison of Emergency and Elective Carotid Artery Stenting Treatments: A Single-Center Experience

Introduction:This study aimed to compare the clinical and radiological outcomes of emergency and elec tive carotid artery stenting (CAS) in symptomatic carotid artery stenosis.Materials and Methods: A retrospective analysis was conducted on 115 patients who underwent CAS for internal carotid artery (ICA) stenosis in our center between January 2020 and May 2023.Patients were categorized as emergency or elective CAS.Data on demographics, comorbidities, antiplatelet use, symptomatic status, acute ischemic infarction history, stenosis degree, plaque characteristics, procedural details (predilatation, embolic protection, complications), intensive care need (>48 hours), hosp ital stay, and mortality rate were recorded.Results: Of 115 patients, 68 (59.1%) were male, with a mean age of 69.87 9.17 years.Hypertension (73.9%) was the most common comorbidity.Elective CAS was performed in 96 patients (83.5%) and emergency CAS in 19 (16.5%).Emergency CAS patients had hi gher rates of ulcerated plaques (47.4% vs. 13.5%),cerebral infarction (84.2% vs. 3.1%), dissection (26.3% vs. 0%), and plaque thrombus (26.3% vs. 1%).Hospital stay was longer in the emergency CAS group (4.74 2.07 vs. 3.63 2.05 days).Myocardial infarction (0% vs .1%), extracranial complications (5.3% vs. 1%), and mortality (10.5% vs. 3.1%) did not differ significantly.In patients with severe stenosis (90%), the rate of tandem lesions was higher, periprocedural mortality and prolonged intensive care duration and the rate of predilatation application were significantly higher compared to t he other groups.Conclusion: Emergency CAS is feasible and effective in selected high-risk patients with symptomatic carotid stenosis.However, given the higher risk profile, careful patient selection and perioperative management are crucial.