Long-term results of carotid endarterectomy and carotid stenting.

Acta Neurochir Suppl

Department of Neurosurgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fushimi-kuFushimi-ku, Kyoto 612-8555, Japan.

Published: April 2010

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.

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http://dx.doi.org/10.1007/978-3-211-99373-6_16DOI Listing

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