Introduction There is a high prevalence of comorbid carotid artery stenosis in patients with atrial fibrillation, with some studies suggesting rates as high as 71% (2). Stenting is a common treatment for symptomatic stenosis. However, the best preventive therapy for this population is still undetermined.

Aim of Study Our goal is to identify the safest and most effective secondary prevention treatment for patients with concurrent atrial fibrillation who undergo stent-assisted percutaneous transluminal angioplasty (SAPTA).

Methods We 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 ’triple therapy’ involving DAPT and an anticoagulant. Secondary outcomes reviewed were strokes following the procedure, stent occlusion, non-major bleeding events, and all-cause mortality.

Results Major bleeding 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).

Conclusion There is significant variability in current practices regarding the treatment regimen for patients with coexisting atrial fibrillation after SAPTA. Our data suggest that the risk of major bleeding events and the risk of recurrent strokes are the same across all three groups.