[Stenting versus carotid endarterectomy for carotid stenosis. A single center experience].

Abstract

AIM:

The objective was to compare Carotid Endarterectomy (CEA) with Carotid Artery Stenting (CAS) in terms of efficacy and safety in patients with symptomatic and asymptomatic extracranial carotid stenosis.

MATERIALS:

This study enrolled 285 patients with symptomatic and asymptomatic carotid stenosis that underwent either to CAS or CEA. The primary end-points were death, stroke and myocardial infarction. The secondary end-points were restenosis and nerve injury. The Data emerged from the follow-up at 1,3,6,12,24 months that provided for clinical and EcocolorDoppler monitoring. A separate analyse was performed evaluating the prediction of the Ultrasonographic appearance of the atheroma on the symptomatic nature of the lesion.

RESULTS:

The percentage of neurological symptomatology in the periprocedural period was higher in CAS than in CEA group (9% vs 3%). We didn't report any case of periprocedural death. The results from the follow-up are: myocardial infarction 5% CAS vs 7% CEA; stroke 5% CAS vs 4% CEA; restenosis 3% CAS vs 6% CEA; nerve injury 0% CAS vs 1% CEA; mortality 0% CAS vs 1% CEA.

DISCUSSION:

CEA is the gold standard for treatment of significant carotid stenosis, although endovascular technique is emerging as a less invasive alternative. CAS has presented a less frequence of myocardial infarction, nerve injury and long-term mortality, but it showed an higher percentage of neurological events both in short and long-term. This last aspect is correlated with the plaque structure. Ultrasonographic study of the atheroma has become a defining moment in the choice of the therapeutic strategy.

• Authors: Francesca Frezzotti, Leslie Fiengo, Federico Bucci, Christian Brogna, Rita Mele, Adriano Redler
• Journal: Annali italiani di chirurgia (Ann Ital Chir) 2012 Jul-Aug Vol. 83 Issue 4 Pg. 291-6 ISSN: 0003-469X [Print] Italy
• Vernacular Title: Stenting Carotideo e Endoarterectomia Carotidea Esperienza di un singolo Centro.
• PMID: 22759467 (Publication Type: Comparative Study, English Abstract, Journal Article)

Topics

• Carotid Stenosis (surgery)
• Endarterectomy, Carotid
• Female
• Humans
• Male
• Stents