Comparison of Carotid Artery Stenting and Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Single Center Study
- 282 Downloads
Carotid artery stenting (CAS) is believed to be an alternative to carotid endarterectomy (CEA); however, recent studies have demonstrated an increase of complications with stenting that does not reflect our experience. We thus wanted to compare the periprocedural and 1-year follow-up outcomes of CAS with those of CEA among patients with symptomatic extracranial carotid stenosis in a population from eastern Turkey.
The hospital records of all patients who underwent carotid artery revascularization were retrospectively reviewed. Patients were divided into two groups based on the type of carotid revascularization performed, namely CEA or CAS. Comparisons were made with respect to 30-day and 1-year outcomes of transient ischemic attack (TIA), myocardial infarction (MI), stroke, and all-cause death rates. Composite endpoints for both groups were also analyzed.
Thirty-two CEA and 33 CAS procedures were performed for symptomatic occlusive carotid disease. Baseline characteristics were similar between both groups except for the incidence of diabetes mellitus. No significant differences were found with respect to 30-day mortality, MI, and neurologic morbidity endpoints for CEA and CAS procedures. In the postprocedural 1-year follow-up, only TIA was observed to be significantly higher in the CAS group; the other endpoints did not differ significantly. One-year composite endpoints did not differ between both groups (log-rank P = 0.300).
In our trial of patients with symptomatic carotid artery stenosis, no significant difference could be shown in periprocedural outcomes, postprocedural outcomes except TIA, and in composite endpoints between the CEA and CAS groups. CAS is a safe and efficacious alternative for the treatment of symptomatic carotid artery stenosis.
KeywordsCardiology Carotid artery stenting Carotid endarterectomy Carotid stenosis Stroke
No funding or sponsorship was received for this study or publication of this article.
Dr. Taş is the guarantor for this article, and takes responsibility for the integrity of the work as a whole.
Conflict of interest
M. Hakan Taş, Ziya Şimşek, Abdurrahim Colak, Yavuzer Koza, Pinar Demir, Recep Demir, Ugur Kaya, Ibrahim Halil Tanboga, Fuat Gundogdu and Serdar Sevimli declare that they have no conflicts of interest.
Compliance with ethics guidelines
The study conformed to the principles of the Helsinki Declaration of 1975, as revised in 2000 and was approved by the Atatürk University Medical Faculty Ethics Committee. The analysis in this article is based on previously collected data and does not involve any new studies of human or animal subjects performed by any of the authors.