A Review of Studies Comparing the Effect of Endovascular and Surgical Treatment of Internal Carotid Artery Stenosis

Czech version

Authors: D. Krajíčková ^1,2; A. Krajina ^1,3
Authors‘ workplace: LF UK a FN Hradec Králové Komplexní cerebrovaskulární centrum ¹; LF UK a FN Hradec Králové Neurologická klinika ²; LF UK a FN Hradec Králové Radiologická klinika ³
Published in: Cesk Slov Neurol N 2016; 79/112(2): 173-177
Category: Review Article

Overview

The authors present a systematic review of recent large randomized studies comparing short and long-term effect of endovascular and surgical treatment of the internal carotid artery stenosis at its origin. The studies showed similar beneficial long-term effect of both methods. Higher rate of complications in angioplasty is caused by minor debilitating ischemic strokes in the periprocedural period while the endarterectomy has higher risk of myocardial infarction. Experience of the operator and appropriate patient indication for therapy are crucial for treatment success. Patients should be treated in centers in which both methods are routinely available with lower rate of complications.

Key words:
carotid stenting – carotid endarterectomy –randomized study – periprocedural complications – long-term outcomes

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Sources

1. Kinlay S. Fire in the hole: carotid stenting versus endarterectomy. Circulation 2011;123(22):2522– 5. doi: 10.1161/ CIRCULATIONAHA.111.034314.

2. Ederle J, Featherstone RL, Brown MM. Randomized controlled trials comparing endarterectomy and endovascular treatment for carotid artery stenosis. A Cochrane systematic review. Stroke 2009;40(4):1373– 80. doi: 10.1161/ STROKEAHA.108.531228.

3. Yadav JS, Wholey MH, Kuntz RE, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med 2004;351(15):1493– 501.

4. Massop D, Dave R, Metzger C, et al. Stenting and angioplasty with protection in patients at high-risk for endarterectomy. SAPPHIRE Worldwide Registry first 2,011 patients. Catheter Cardiovasc Interv 2009;73(2):129– 36. doi: 10.1002/ ccd.21844.

5. Wimmer NJ, Yeh RW, Cutlip DE, et al. Risk prediction for adverse events after carotid stenting in higher surgical risk patients. Stroke 2012;43(12):3218– 24. doi: 10.1161/ STROKEAHA.112.673194.

6. Macdonald S. Carotid artery stenting trials: conduct, results, critique, and current recommendations. Cardiovasc Intervent Radiol 2012;35(1):15– 29. doi: 10.1007/ s00270-011-0223-x.

7. Mas JL, Trinquart L, Leys D, et al. Endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis (EVA-3S) trial: results up to 4 years from a randomized, multicentre trial. Lancet Neurol 2008;7(10):885– 92. doi: 10.1016/ S1474-4422(08)70195-9.

8. Fiehler J, Bakke SJ, Clifton A, et al. Plea of the defence – critical comments on the interpretation of EVA-3S, SPACE and ICSS. Neuroradiology 2010;52(7):601– 10. doi: 10.1007/ s00234-010-0707-4.

9. Naggara O, Touzé E, Beyssen B, et al. Anatomical and technical factors associated with stroke or death during carotid angioplasty and stenting. Results from the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S) trial and systemic review. Stroke 2011;42(2):380– 8. doi: 10.1161/ STROKEAHA.110.588772.

10. Ringleb PA, Allenberg JR, Bruckmann H, et al. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomized non-inferiority trial. Lancet 2006;368(9543):1239– 47.

11. Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the stent-protected angioplasty versus carotid endarterectomy (SPACE) study to treat symptomatic stenosis at 2 years: a multinational, prospective, randomized trial. Lancet Neurol 2008;7(10):893– 902. doi: 10.1016/ S1474-4422(08)70196-0.

12. Jansen O, Fiehler J, Hartmann M, et al. Protection or nonprotection in carotid stent angioplasty. The influence of interventional techniques on outcome data from the SPACE trial. Stroke 2009;40(3):841– 6. doi: 10.1161/ STROKEAHA.108.534289.

13. Ederle J, Dobson J, Featherstone RL, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomized controlled trial. Lancet 2010;375(9719):985– 97. doi: 10.1016/ S0140-6736(10)60239-5.

14. Berkefeld J, Chaturvedi S. The International Carotid Stenting Study and the North American Carotid Revascularization Endarterectomy versus Stenting Trial. Fueling the debate about carotid artery stenting. Stroke 2010;41(11):2714– 5. doi: 10.1161/ STROKEAHA.110.596833.

15. Mas JL, Arquizan C, Calvet D, et al. Long-term follow-up study of endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis trial. Stroke 2014,45(9):2750–6. doi:10.1161/STROKEAHA.114.005671.

16. Gensicke H, Zumbrunn T, Jongen LM, et al. Characteristics of ischemic brain lesions after stenting or endarterectomy for symptomatic carotid artery stenosis. Results from the international carotid stenting study – magnetic resonance imaging substudy. Stroke 2013;44(1):80– 6. doi: 10.1161/ STROKEAHA.112.673152.

17. Bonati LH, Dobson J, Featherstone RL, et al. Long-term outcomes after stenting versus endarterectomy of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomized trial. Lancet 2015;385(9967):529– 38. doi: 10.1016/ S0140-6736(14)61184-3.

18. Sulter G, Steen C, De Keyser J. Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke 1999;30(8):1538– 41.

19. Brott TG, Hobson RW, Howard G, et al. Stenting versus endarterectomy for treatment of carotid artery stenosis. N Engl J Med 2010;363(1):11– 23. doi: 10.1056/ NEJMoa0912321.

20. Howard JV, Voeks JH, Lutsep HL, et al. Does sex matter? Thirty-day stroke and death rates after carotid artery stenting in women versus men. Results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) lead-in phase. Stroke 2009;40(4):1140– 7. doi: 10.1161/ STROKEAHA.108.541847.

21. Pierot L, van der Bom IMJ, Wakhloo AK. Advances in stroke. Advances in interventional neuroradiology. Stroke 2012;43(2):310– 3. doi: 10.1161/ STROKEAHA.111.642652.

22. Voeks JH, Howard G, Roubin GS, et al. Age and outcomes after carotid stenting and endarterectomy: the carotid revascularization endarterectomy versus stenting trial. Stroke 2011;42(12):3484– 90. doi: 10.1161/ STROKEAHA.111.624155.

23. Silver FL, Mackey A, Clark WM, et al. Safety and stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Stroke 2011;42(3):675– 80. doi: 10.1161/ STROKEAHA.110.610212.

24. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA 1995;273(18):1421– 8.

25. Halliday A, Mansfield A, Marro J, et al. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomized controlled trial. Lancet 2004;363(9420):1491– 502.

26. Calvet D, Mas J-L, Algra A, et al. Carotid stenting. Is there an operator effect? A pooled analysis from the Carotid Stenting Trialists’ Collaboration. Stroke 2014;45(2):527– 32. doi: 10.1161/ STROKEAHA.113.003526.

27. Setacci C, Chisci E, Setacci F, et al. Siena carotid artery stenting score. A risk modelling study for individual patients. Stroke 2010;41(6):1259– 65. doi: 10.1161/ STROKEAHA.110.578583.

28. Fiehler J, Jansen O, Berger J, et al. Differences in complication rates among the centers in the SPACE study. Neuroradiology 2008;50(12):1049– 53. doi: 10.1007/ s00234-008-0459-6.

29. Bonati LH, Dobson J, Algra A, et al. Short-term outcomes after stenting versus endarterectomy for symptomatic carotid stenosis. A preplanned meta-analysis of individual patient data. Lancet 2010;376(9746):1062– 73. doi: 10.1016/ S0140-6736(10)61009-4.

30. Hobson RW, Howard VJ, Roubin GS, et al. Carotid artery stenting is associated with increased complications in octogenarians: 30-day stroke and death rates in the CREST lead-in phase. J Vasc Surg 2004;40(6):1106– 11.

31. Chiam PT, Roubin GS, Iyer SS, et al. Carotid artery stenting in elderly patients: importance of case selection. Catheter Cardiovasc Interv 2008;72(3):318– 24. doi: 10.1002/ ccd.21620.

32. Naylor AR. A surgeon view on endarterectomy and stenting in 2011: lest we forget, it’s all about preventing stroke. Cardiovasc Intervent Radiol 2012;35(2):225– 33. doi: 10.1007/ s00270-011-0282-z.

33. Beneš V, Netuka D, Charvát F, et al. Stenóza vnitřní krkavice – endarterektomie nebo stent? Cesk Slov Neurol N 2008;71/ 104(4):388– 99.