Comparison of Endovascular and Open Carotid Artery Treatment in Germany: A Retrospective Analysis from 2010 to 2015

  • Patrick FreyhardtEmail author
  • Olga von Beckerath
  • Ralf Dörbecker
  • Peter Schott
  • Birgit Aufmesser-Freyhardt
  • Marcus Katoh
  • Knut Kröger
Clinical Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions



We analyzed trends in carotid artery stenting (CAS) and carotid endarterectomy (CEA) in hospitalized cases in Germany in the years 2010–2015.


Data from national statistics (DRG statistics) published by the Federal Statistical Office in Germany describing the number of hospitalized patients treated with CEA and CAS were used. In addition, numbers of patients hospitalized with the principal diagnosis stroke associated with precerebral lesions (ICD code I63), transitory cerebral ischemic attacks (G45) and precerebral carotid artery stenosis (I65) treated by CEA and CAS were analyzed for the year 2015.


Total number of CEA decreased by 4.0% from 24.067 (2010) to 23.104 (2015) and CAS increased by 5.1% from 5.703 to 5.992. In 2015, 79.4% of all procedures coded concerning the internal carotid artery were CEA and 21.6% CAS. From 27.798 cases hospitalized with the principal diagnosis stroke associated with precerebral lesions, CEA was performed in 3.921 (14.1%) and in 2.132 (7.7%) CAS was documented, with CAS making up one-third of all treatments within the stroke group. In 28.273 cases hospitalized with a TIA, CEA was specified in 853 (3.0%) and CAS in 255 (0.9%) cases. In 27.553 cases with an occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, 17.036 (61.8%) had a CEA and 3.156 (11.5%) a CAS procedure.


CEA is still the primary treatment of extracranial artery stenosis. The impact of CAS becomes mainly apparent in cases presenting with acute strokes.


Carotid artery stenting Carotid endarterectomy Precerebral carotid artery stenosis Stroke Transitory cerebral ischemic attacks 



We thank Referat VIII A from the Federal Statistical Office for extracting and providing the data from the DRG statistic.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyHELIOS Klinikum KrefeldKrefeldGermany
  2. 2.University Witten/HerdeckeWittenGermany
  3. 3.Department of Vascular MedicineHELIOS Klinikum KrefeldKrefeldGermany

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