Long-term results of carotid endarterectomy and carotid stenting.

ABSTRACT

INTRODUCTION: We report the long-term results of surgery for carotid stenosis in our institute, and suggest a better treatment strategy for high-risk patients. MATERIALS AND METHODS: Our series of 352 carotid surgeries conducted between April 1998 and May 2007 were investigated. CEA comprised 134 (38%), whereas CAS comprised 218 (62%). In August 2007, we sent questionnaires to all patients, and analyzed responses up to May 2008. For patients undergoing regular follow-up, the data were gathered from the medical records. The questions were (1) mRS at that time, (2) the cause of death if the patient was deceased, (3) newly diagnosed stroke, and (4) newly diagnosed coronary heart disease. RESULTS: The response rate was 68.8%. The average follow-up period was 31.2 months. The average differences in mRS pre- and postoperation were -0.33 and -0.48 in CEA and CAS, respectively. The mortality rate at >30days was 8.2% in CEA, and 5.0% in CAS. The leading cause of death was heart disease (31.8%). CONCLUSION: Our report suggests that CAS is not inferior to CEA, and both procedures can be managed safely if all characteristics of the carotid lesions are considered.