Akademik Veri Yönetim Sistemi
Open Exploration Publishing, cilt.2, 2023 (Hakemli Dergi)
Abstract
Aim: One of the main risk factors for an ischemic stroke is significant carotid artery stenosis, and
extracranial severe carotid artery stenosis accounts for 20% of ischemic strokes. Prior to the development
of carotid artery stenting (CAS), the only effective and reliable treatment for carotid artery stenosis was
carotid endarterectomy (CEA). This study compares the results of CAS and CEA in patients with significant
carotid artery stenosis.
Methods: Between 2018 and 2022, hospital records of all patients who underwent carotid artery
revascularization at the institution were retrospectively analyzed. Patients were divided into two groups
depending on whether CEA or CAS was performed for carotid revascularization. Propensity score matching
was performed to reduce bias by equating the baseline clinical characteristics of the groups. To compare
30-day, 1-year, and long-term outcomes, rates of transient ischemic attack (TIA), myocardial infarction,
stroke, all-cause mortality, and composite endpoints were analyzed.
Results: After PSM, 76 patients each in the CEA and CAS groups were compared. The mean age was
69.80 years ± 11.35 years and 121 (80%) were male. The patients were followed up for a mean of
33 months ± 6 months. The incidence of TIA in the perioperative period [9 (12%) vs. 4 (5%); P < 0.05], TIA
and composite endpoint at 1-year period [11 (15%) vs. 2 (3%); P < 0.05 and 27 (36%) vs. 16 (21%); P <
0.05, respectively] were significantly higher in the CAS group than in the CEA group. No difference was
observed between the groups in the long-term.
Conclusions: There was no noticeable difference between the CEA and CAS groups in the examination of
cases with severe carotid artery stenosis in terms of 1-month, and 1-year results (apart from TIA and
composite endpoints), or long-term outcomes. Extracranial carotid artery stenosis can be treated safely and
effectively also by CAS.