Efficacy of stent combined with medication versus medication alone in the treatment of severe carotid artery stenosis
10.3969/j.issn.1002-0152.2025.07.002
- VernacularTitle:支架联合药物和单纯药物治疗颈动脉重度狭窄的疗效观察
- Author:
Dejie DU
1
;
Guangwen LI
;
Rui MA
;
Xiaojie WANG
;
Runze ZHOU
;
Dongcheng XU
Author Information
1. 山东省莒县人民医神经内科(日照 276500)
- Publication Type:Journal Article
- Keywords:
Extracranial carotid artery;
Stenosis rate;
Stent;
Medical therapy;
Follow-up
- From:
Chinese Journal of Nervous and Mental Diseases
2025;51(7):391-396
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the therapeutic efficacy of stenting combined with medication versus medication alone in treating severe extracranial carotid artery stenosis.Methods This prospective,multicenter cohort study enrolled 337 patients with carotid artery stenosis ranging from 70%to 99%.Based on patient preference,they were divided into two groups:a stent combined with medication group(antiplatelet drugs+statins,n=169)and a medication-only group(n=168).The study assessed perioperative safety and the incidence of recurrent cerebrovascular events related to the target vessel within one year.Results The success rate of the stent combined with medication group was 100%.There was one case of hyperperfusion-related intracranial hemorrhage during the perioperative period(1/169)The patient recovered well after medical treatment.There was no statistically significant difference in perioperative complications between the two groups(P=0.318).During the 1-year follow-up,the stent combined with medication group(3/169)had a significantly lower incidence of recurrent ischemic stroke compared to the medication-only group(15/168),with a statistically significant difference(P=0.003).Univariate analysis showed that gender(χ2=4.372,P=0.037),stenosis rate≥85%(χ2=10.738,P=0.001),and non-stent treatment(χ2=7.171,P=0.007)were risk factors for recurrent stroke.However,the number of recurrent ischemic strokes in females was relatively small and after adjusting the chi-square test,the difference was not statistically significant(P=0.075).Logistic regression analysis revealed that stenosis rate≥85%(OR=115.925,95%CI:2.077-122.102,P=0.008)and non-stent treatment(OR=0.158,95%CI:0.044-0.564,P=0.004)were independent risk factors for recurrent cerebrovascular events within one year.Conclusions In patients with≥85%extracranial carotid artery stenosis,stenting combined with medication reduces recurrent ischemic cerebrovascular events within 1 year.
