Periprocedural clinical outcomes of stenting and endarterectomy in patients with carotid artery stenosis

Year 2024, Volume: 49 Issue: 3, 744 - 750, 30.09.2024

Derya Özdoğru , Onur Kadir Uysal , İlker Öztürk , Candan Cudi Ökten , Burak Ademoğlu , Zülfikar Arlıer

https://doi.org/10.17826/cumj.1493108

Abstract

Purpose: To identify the chief pathological cause of extracranial cerebrovascular disease, which is atherosclerosis, we analyzed and compared the early and 6-month morbidity and mortality rates of patients who underwent carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis.
Materials and Methods: We retrospectively included patients who had undergone surgical endarterectomy and endovascular carotid stent implantation for carotid artery stenosis between April 2019 and August 2022. We evaluated neurological examinations, routine blood tests, neurological and systemic complications, mortality rates, and follow-up colour Doppler ultrasonography 6 months post-discharge.
Results: The study included a total of 300 patients, with 52.7% (n = 158) undergoing CEA and 47.3% (n = 142) undergoing endovascular stent implantation (CAS). The patients’ average ages were 66±8 years in the CEA group and 70±7.4 years in the CAS group, suggesting that those undergoing CAS were generally older. Notably, there were significantly more instances of congestive heart failure and a history of cerebrovascular disease within the CAS group compared to the CEA group. However, no significant difference was observed in the rates of postprocedural complications. Furthermore, there were no cases of mortality reported in either group.
Conclusion: The preferred method for treating severe carotid artery stenosis should be determined by considering patient characteristics and preferences, as well as the complication rates in the centre.

Keywords

carotid endarterectomy, carotid artery stenting, carotid artery stenosis, restenosis

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Karotis arter darlığı olan hastalarda uygulanan stent ve endarterektominin işlem sürecindeki klinik sonuçları

Abstract

Amaç: Ekstrakraniyal serebrovasküler hastalığın primer patolojik nedeni aterosklerozdur. Karotis arter darlığı nedeniyle karotis endarterektomi (CEA) ve karotis arter stentleme (CAS) yapılan hastaların erken ve ilk 6 aylık morbidite ve mortalite sonuçlarını karşılaştırdık.
Gereç ve Yöntem: Nisan 2019 ile Ağustos 2022 tarihleri arasında karotis arter darlığı nedeniyle cerrahi endarterektomi ve endovasküler karotis stent implantasyonu uygulanan 300 hasta retrospektif olarak çalışmaya dahil edildi. Nörolojik muayeneler, rutin kan testleri, nörolojik ve sistemik komplikasyonlar, mortalite oranları ve taburcu olduktan 6 ay sonraki renkli doppler ultrasonografi takipleri retrospektif olarak değerlendirildi.
Bulgular: Karotis endarterektomi (CEA) uygulanan %52,7 (n = 158) ve endovasküler stent implantasyonu (CAS) uygulanan %47,3 (n = 142) olmak üzere toplam 300 hasta çalışmaya dahil edildi. Hastaların yaş dağılımı CEA grubunda 66±8 yıl ve CAS grubunda 70±7,4 yıl olup, CAS uygulanan hastalar daha yaşlıydı. Konjestif kalp yetmezliği tanısı ve serebrovasküler hastalık öyküsü CAS grubunda CEA grubuna göre anlamlı olarak daha yaygındı. İşlem sonrası komplikasyon oranlarında anlamlı bir fark yoktu. Her iki grupta da mortalite gözlenmedi.
Sonuç: Ciddi karotis arter stenozunun tedavisinde seçilecek yöntemin hasta özellikleri ve tercihinin yanı sıra merkezdeki komplikasyon oranları da göz önünde bulundurularak yapılması uygun olacaktır.

Keywords

Karotis endarterektomi, karotis arter stentleme, karotis arter darlığı, restenoz

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