Results of a Comparison between Carotid Endarterectomy and Carotid Stenting – Single Institution Experience

Czech version

Authors: V. Beneš ¹; D. Netuka ¹; F. Charvát ²; M. Mohapl ¹; F. Kramář ¹; S. Ostrý ¹; J. Mašková ²; J. Lacman ²
Authors‘ workplace: Neurochirurgická klinika 1. LF UK, IPVZ a ÚVN Praha ¹; Radiodiagnostické oddělení ÚVN Praha ²
Published in: Cesk Slov Neurol N 2008; 71/104(4): 400-404
Category: Review Article

Podpořeno IGA MZCR NR/9435-3.

Overview

Introduction:
Carotid endarterectomy (CEA) is a well established procedure for atherosclerotic disease of the internal carotid artery. The indications for carotid artery stenting (CAS), however, are still evolving as it is a much newer technique. The results of CEA and CAS are analysed here.

Material and methods:
Carotid endarterectomy has been perfomed by the authors since 1982. This procedure was used by the authors in 1271 cases by July 2007 (at Ústí nad Labem Hospital until 1997, and later at the Central Military Hospital in Prague). Carotid stenting has been carried out at the Radiodiagnostic Unit of the Central Military Hospital, since 1999. This procedure has been perfomed in 363 cases.

Results:
Thirty-day morbidity/mortality (M/M) was 2.04% in CEA group, 4.68% in CAS group. Transient ischemic attack (TIA) within 30 days of procedure was observed in 1.49% of CEA cases, and in 7.43% of CAS cases. Local complications were observed in 6.29% of CEA cases, and in 7.98% of CAS cases. Cranial nerve injury was observed in CEA group only, in 3.93% of cases. Wound revision was performed in 2.98% of cases. Minor complications were observed in 10.07% of CEA cases, and in 17.63% of CAS cases.

Conclusions:
Thirty-day M/M and frequency of post-procedure TIA are lower in CEA group at our institution. According to our results we recommend CEA as the primary treatment procedure. We recommend performing CAS for atherosclerotic carotid artery disease within international registries and randomized studies.

Key words:
carotid artery – stenosis – endarterectomy – stenting

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