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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Early restenosis after eversion carotid endarterectomy versus carotid stenting: a single-centre retrospective study
K HIRSCHBERG1, E DOSA, K HUTTL
1Department of Cardiovascular Surgery, Faculty of Medicine, Semmelweis University Budapest, Hungary. hirschbergkristof@gmail.com
Insights
Carotid artery stenting (CAS) showed lower restenosis rates compared to carotid endarterectomy (CEA). However, CAS procedures had more perioperative complications than CEA.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Atherosclerotic disease of the carotid arteries poses a significant stroke risk.
- Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established revascularization procedures.
- Comparative data on early restenosis and perioperative outcomes are crucial for clinical decision-making.
Purpose of the Study:
- To compare the early restenosis rates between CAS and CEA.
- To evaluate and compare perioperative outcomes in patients undergoing CAS versus CEA.
Main Methods:
- Retrospective analysis of 368 CEAs and 144 CAS procedures performed between 2004 and 2004.
- Kaplan-Meier method for restenosis rate calculation; log-rank test for group comparison.
- Chi-square test for perioperative outcome comparison; mean follow-up of 18.4 months.
Main Results:
- CAS group experienced significantly higher rates of transient neurological (7.60% vs 2.20%) and cardiovascular (4.10% vs 1.10%) complications.
- Restenosis rates were significantly lower after CAS compared to CEA (moderate: 4.86% vs 11.41%; severe: 3.47% vs 10.05%).
Conclusions:
- Carotid artery stenting is associated with a lower incidence of restenosis compared to carotid endarterectomy.
- Carotid endarterectomy demonstrates a safer perioperative profile with fewer complications than carotid artery stenting.
Aim:
The aim of our study was to compare the early restenosis rate between patients undergoing carotid artery stenting (CAS) and carotid endarterectomy (CEA) at a single cardiovascular institution.
Methods:
In 2004, 368 carotid endarterectomies were carried out on 347 patients and 144 internal carotid artery stentings were performed on 140 patients. The mean follow-up time was 18.4 months (range 6-38 months). Restenosis rates were calculated with the Kaplan-Meyer method and the two groups were compared by using log-rank test. Perioperative outcome was also evaluated and the groups were compared with chi-square test.
Results:
Significantly more perioperative complications occurred in the CAS group, mainly transient neurological (7.60% vs 2.20% in the CEA group, P<0.05) and cardiovascular symptoms (4.10% vs 1.10% in the CEA group, P<0.05). Moderate restenosis (50-69%) occurred in 11.41% (42/368) of CEA cases and in 4.86% (7/144) of CAS cases (P<0.05). Severe (70%) restenosis rates were 10.05 % in the CEA group and 3.47% in the CAS group (P<0.05).
Conclusions:
Incidence of restenosis after carotid artery stening was less common than after carotid endarterectomy. On the other hand, perioperative complications were recorded more often after CAS than following CEA.