Periprocedural clinical outcomes of stenting and endarterectomy in patients with carotid artery stenosis
Abstract
Purpose: To identify the chief pathological cause of extracranial cerebrovascular disease, which is atherosclerosis, we analyzed and compared the early and 6-month morbidity and mortality rates of patients who underwent carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis.
Materials and Methods: We retrospectively included patients who had undergone surgical endarterectomy and endovascular carotid stent implantation for carotid artery stenosis between April 2019 and August 2022. We evaluated neurological examinations, routine blood tests, neurological and systemic complications, mortality rates, and follow-up colour Doppler ultrasonography 6 months post-discharge.
Results: The study included a total of 300 patients, with 52.7% (n = 158) undergoing CEA and 47.3% (n = 142) undergoing endovascular stent implantation (CAS). The patients’ average ages were 66±8 years in the CEA group and 70±7.4 years in the CAS group, suggesting that those undergoing CAS were generally older. Notably, there were significantly more instances of congestive heart failure and a history of cerebrovascular disease within the CAS group compared to the CEA group. However, no significant difference was observed in the rates of postprocedural complications. Furthermore, there were no cases of mortality reported in either group.
Conclusion: The preferred method for treating severe carotid artery stenosis should be determined by considering patient characteristics and preferences, as well as the complication rates in the centre.
Keywords
carotid endarterectomy, carotid artery stenting, carotid artery stenosis, restenosis
Supporting Institution
yok
Thanks
yok
References
- Goldstein LB. Introduction for focused updates in cerebrovascular disease. Stroke. 2020;51:708-10.
- Rothwell PM, Eliasziw M, Gutnikov SA, Fox A, Taylor D, Mayberg M et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet. 2003;361:107–16.
- Economopoulos KP, Sergentanis TN, Tsivgoulis G, Mariolis AD, Stefanadis C. Carotid artery stenting versus carotid endarterectomy: a comprehensive meta-analysis of short-term and long-term outcomes. Stroke. 2011;42:687–92.
- Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351:1379-87.
- Ederle J, Dobson J, Featherstone RL, Bonati LH, van der Worp HB, Borst GJ et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interimanalysis of a randomised controlled trial. Lancet. 2010;375:985-97.
- Boztosun B, Can MM, Kocabay G. Karotis arter endarterektomisine karşı karotis artere stent: Bugün nerede duruyoruz? Turk Kardiyol Dern Ars. 2012;40:642-9.
- Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R et al. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet 2021;398:1065–73.
- Faries PL, Chaer RA, Patel S, Lin SC, DeRubertis B, Kent KC et al. Current management of extracranial carotid artery disease. Vasc Endovasc Surg. 2006;40:165-75.
- Setacci C, Sterpetti A, de Donato G. Introduction: Carotid endarterectomy versus carotid stenting-A never-ending story. Semin Vasc Surg. 2018;31:1–3.
- Columbo JA, Martinez-Camblor P, MacKenzie TA, Kang R, Trooboff, SW, Goodney P et al. A comparative analysis of long-term mortality after carotid endarterectomy and carotid stenting. J Vasc Surg. 2019;69:104-9.
