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Carotid Endarterectomy and Carotid Artery Stenting in the Light of ICSS and CREST Studies

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Trends in the Management of Cerebrovascular Diseases

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 129))

Abstract

Objective. We analyzed the results of internal carotid artery (ICA) stenosis treatment at our institution according to the treatment modality—carotid endarterectomy (CEA) vs. carotid artery stenting (CAS).

Methods. During 2003–2015, a total of 1894 procedures were performed for ICA stenosis. CEA was done in 1064 cases and CAS in 830 cases.

The primary outcome was disabling stroke (mRS > 2) or myocardial infarction within 30 days of treatment. Secondary outcomes were transitory ischemic attacks (TIAs), minor strokes (stroke without impaired activities of daily living), and any other significant complications.

Results. Major mortality and morbidity were divided according to their treatment groups; this reached 0.9% in the CEA and 2.5% in the CAS group (p = 0.007). Minor stroke was recorded at 1.5% and 2.7% in the CEA and CAS groups (p = 0.077), TIAs in 1.0% (CEA) and 4.0% (CAS) (p < 0.001), and any complication in 12.4% (CEA) and 13.0% (CAS) (p = 0.694).

Conclusions. CEA is a safe procedure in patients who meet the correct treatment indications. In all subgroup analyses CEA proved to be equal to or better than CAS. This study supports the idea of CEA being the preferred treatment and CAS being reserved for selected cases only.

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Acknowledgments

Supported by grants AZV 16-29148A and MO1012.

Conflict of interest The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, First Medical Faculty, Military University Hospital and Charles University, Prague, Czech Republic

    V. Benes M.D., Ph.D. & O. Bradac M.D., M.Sc., Ph.D.

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  1. V. Benes M.D., Ph.D.
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  2. O. Bradac M.D., M.Sc., Ph.D.
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Corresponding author

Correspondence to O. Bradac M.D., M.Sc., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Giuseppe Esposito

  2. Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Luca Regli

  3. Department of Neurosurgery, Asahi Uni Murakami Memorial Hospital, Gifu, Japan

    Yasuhiko Kaku

  4. Department of Neurosurgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan

    Tetsuya Tsukahara

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Benes, V., Bradac, O. (2018). Carotid Endarterectomy and Carotid Artery Stenting in the Light of ICSS and CREST Studies. In: Esposito, G., Regli, L., Kaku, Y., Tsukahara, T. (eds) Trends in the Management of Cerebrovascular Diseases. Acta Neurochirurgica Supplement, vol 129. Springer, Cham. https://doi.org/10.1007/978-3-319-73739-3_14

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  • DOI: https://doi.org/10.1007/978-3-319-73739-3_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-73738-6

  • Online ISBN: 978-3-319-73739-3

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