Comparing carotid endarterectomy and carotid artery stenting: retrospective single-center analysis

Ann Palliat Med. 2022 Nov;11(11):3409-3416. doi: 10.21037/apm-22-797. Epub 2022 Nov 7.

Abstract

Background: Extracranial cerebrovascular diseases represent approximately 20% of ischemic stroke cases. Carotid endarterectomy (CEA) was the gold standard procedure for carotid artery stenosis treatment until the introduction of carotid artery stenting (CAS) in the 1980s. While there have been several multicenter randomized trials comparing CEA and CAS, a more efficacious procedure has not been conclusively distinguished. This study reports the results of CAS versus CEA in patients with symptomatic or asymptomatic carotid stenosis and compares them with those from other studies.

Methods: This study is a single-center retrospective study and included patients who underwent CAS and CEA as elective surgery between January 2012 and December 2020. The final analysis included patient baseline characteristics, postoperative complications, and patient outcomes.

Results: The 235 patients included were assigned to the CAS (n=128) and CEA (n=107) groups. Within 30 days postoperatively, no significant differences were noted in myocardial infarction [n=1, 0.8% (CAS); n=1, 0.9% (CEA); P=0.899], cerebral infarction [n=4, 3.1% (CAS); n=1, 0.9% (CEA); P=0.247], and patient mortality [n=1, 0.8% (CAS); n=0, 0% (CEA); P=0.247].

Conclusions: In elective surgery, CAS and CEA had the same effect of preventing cerebral infarction with no difference in postoperative complications.

Keywords: Carotid endarterectomy (CEA); carotid artery stenting (CAS); retrospective single-center analysis.

Publication types

  • Multicenter Study

MeSH terms

  • Carotid Arteries / surgery
  • Carotid Stenosis* / complications
  • Carotid Stenosis* / surgery
  • Cerebral Infarction / complications
  • Endarterectomy, Carotid* / adverse effects
  • Endarterectomy, Carotid* / methods
  • Humans
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stents / adverse effects
  • Stroke*
  • Treatment Outcome