Comparative Results for the Carotid Artery Stenting Versus Carotid Endarterectomy with Regional Anesthesia: Retrospective Analysis and Review of the Literature

Abstract

Introduction: Carotid artery endarterectomy has already gained acceptance as the standard method for treating extracranial carotid artery stenosis. The last 2 decades have witnessed the increasing popularity of minimally invasive endovascular techniques.Patients and Methods: This study involved a retrospective analysis of 41 patients undergoing stent placement in carotid artery and carotid artery endarterectomy between January 2005 and January 2012 due to carotid artery stenosis. The patients were divided into two groups, group 1 (surgery, n=20) and group 2 (stenting, n=21). The two groups were compared with respect to complications, length of hospitalization, and costs.Results: The mean age was 68.35±8.21 years in group 1 and 66.76±9.16 years in group 2. The mean total cost was 2158.00±801.30 TL (Turkish Lira) for group 1 and 6927.86±2884.72 TL for group 2. The mean length of follow-up was 560.05±232.94/ days in the stenting group and was 933.85±505.45 /days in the surgery group. No statistically significant difference was found between the two groups in terms of age, gender, diabetes mellitus, restenosis, mean duration of hospitalization, and mortality (p>0.05). The only difference was observed in the average cost, which turned out to be lower in group 1 than in group 2 (p

Keywords

• Stents, carotid endarterectomy; anesthesia; regional

Anestezi Altında Karotis Endarterektomi ile Karotis Arter Stentin Karşılaştırmalı Sonuçları: Retrospektif Analiz ve Litaratürün Gözden Geçirilmesi

Abstract

Giriş: Karotis arter endarterektomi ekstrakranial karotis arter stenozunun standart tedavisinde kabul edilmiş bir yöntemdir. Son iki dekatta, minimal invaziv endovasküler teknikler daha popüler hale gelmiştir. Hastalar ve Yöntem: Çalışmamızda Ocak 2005-Ocak 2012 yılları arasında karotis arter tıkanıklığı nedeniyle karotis arter endarterktomi ve karotis artere stent yerleştirilmesi yapılan 41 hasta retrospektif olarak analiz edildi. Hastalar grup 1 (cerrahi, n=20) ve grup 2 (stent, n=21) olarak iki gruba ayrıldı. Hastalar postoperatif komplikasyon, hastane kalış ve maliyet açısından karşılaştırıldı.Bulgular: Ortalama yaş grup 1'de 68,35±8,21 yıl, grup 2'de ise 66,76±9,16 yıl idi. Ortalama toplam maliyet grup 1'de 2158,00±801,30 TL (Türk lirası), grup 2'de 6927,86±2884,72 TL idi. Ortalama takip süresi stent grubu için 560,05±232,94/gün ve cerrahi grup için 933,85±505,45/gün idi. Yaş, cinsiyet, diabetes mellitus, restenoz, ortalama hastanede kalış süresi ve mortalite açısından iki grup arasında fark yoktu. Sadece maliyet grup 1'de grup 2'den daha düşüktü (p>0,05). Sonuç: Son zamanlarda yeni stent ve filtre tipleri rekürren internal karotis arter stenozu olan ve boyuna radyoterapi alan hastalarda tercih edilebilir. Ancak bölgesel anestezi altında karotis endarterektomi stent ile karşılaştırıldığında stent kadar güvenli olup üstelik stentden daha ucuzdur.

Keywords

• Stent, karotis endarterektomisi; bölgesel anestezi

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