CEA versus CAS: short-term and mid-term results.
Int Angiol
; 31(5): 420-6, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-22990503
ABSTRACT
AIM:
Ischemic stroke represents a major health problem and it is an important cause of long-term disability. The aim of this study was to compare short-term and mid-term results of carotid endarterectomy and stenting.METHODS:
During a three-year period, we enrolled 300 patients with carotid stenosis that fit with Stroke Prevention and Educational Awareness Diffusion (SPREAD) guidelines and we performed 150 carotid endarterectomy operations (CEA) and 150 carotid artery stenting procedures (CAS) with distal protection devices. All patients underwent preoperative and postoperative neurological examination, ultrasound imaging, magnetic resonance imaging (MRI) and cognitive tests; moreover all patients were submitted to preoperative, intraoperative and postoperative Transcranial Doppler (TCD) monitoring, in order to detect microembolic signals (MES).RESULTS:
Mortality was zero; two patients developed myocardial infarction in the CEA group during follow-up. The main post-operative results after endarterectomy versus CAS were respectively neurological deficit 1.3% vs. 3.3%, embolic lesions at postoperative MRI 4% vs. 34% and worsening of cognitive tests 4% vs. 25.3%.CONCLUSION:
CEA seems to be the treatment of choice for carotid stenosis, due to its low rate of mortality and morbidity, especially in asymptomatic patients; CAS should be carried out only in particular subgroup of cases, such as restenosis, previous neck surgery or radian therapy, anatomical high bifurcation or extended lesions. Ongoing multicenter randomized trials may give a definitive answer to this matter.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Stents
/
Endarterectomia das Carótidas
/
Estenose das Carótidas
/
Angioplastia com Balão
/
Acidente Vascular Cerebral
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Int Angiol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Itália