Comparison of carotid endarterectomy vs. carotid stent implantation in the treatment of carotid stenosis
10.3760/cma.j.cn113855-20210926-00572
- VernacularTitle:颈动脉内膜剥脱术与颈动脉支架植入术治疗颈动脉狭窄的疗效分析
- Author:
Zhong CHEN
1
;
Yaoguo YANG
;
Xiaobin TANG
;
Lei KOU
;
Sheng WANG
;
Zhangmin WU
;
Hui LIU
;
Nan HE
;
Zheng ZHANG
;
Zike LIANG
;
Hanfang ZHANG
Author Information
1. 首都医科大学附属北京安贞医院血管外科中心，北京 100029
- Keywords:
Carotid stenosis;
Endarterectomy,carotid;
Carotid artery stenting
- From:
Chinese Journal of General Surgery
2022;37(3):169-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare carotid endarterectomy (CEA) and carotid artery stenting (CAS) in perioperative, medium and long term prognosis of patients with carotid artery stenosis.Methods:A retrospective analysis was performed on 1 329 cases of carotid artery stenosis treated at Department of Vascular Surgery, Beijing Anzhen Hospital from Jan 2011 to Aug 2020, as all cases being divided into CAS group and CEA group.Results:There were significant differences in age ( t=0.098, P=0.023) and drinking habits ( χ2=8.055, P=0.005) between the two groups. There were more unstable plaques in CEA group ( χ2=4.392, P=0.038), and more bilateral lesions in CAS group ( χ2=9.673, P=0.038). In perioperative period, there were more mannitol use in CEA group ( χ2=78.614, P<0.001), more incision/puncture site complications ( χ2=5.158, P=0.035), lung infection ( χ2=6.355, P=0.013), cerebral hyperperfusion syndrome (CHS) ( χ2=5.158, P=0.035) and extracranial nerve injury ( χ2=23.760, P<0.001) in CEA group than in CAS group, and more acute renal failure in CAS group ( χ2=10.393, P=0.001). There was no significant difference in survival rate and ischemic stroke, myocardial infarction, cerebral hemorrhage and renal insufficiency between the two groups (all P>0.05). The mean survival time of CAS group was 53.195 months (95% CI: 52.040-54.350), and 54.492 months (95% CI: 53.790-55.195) in CEA group ( P=0.051). Conclusions:Patients in CEA group had more unstable plaque and a lower perioperative stroke rate. CEA group had higher risk of CHS,while CAS was with lower postoperative lung infection rate and less wound local complications. There was no significant difference in long-term survival between the two groups.
