Related Experiment Videos
CEA versus CAS: short-term and mid-term results.
M M G Felli1, A Alunno, A Castiglione
1Paride Stefanini Department of Vascular Surgery, Policlinico Umberto 1, Rome, Italy.
International Angiology : a Journal of the International Union of Angiology
|September 20, 2012
Summary
Carotid endarterectomy (CEA) shows better short-term and mid-term outcomes than carotid artery stenting (CAS) for carotid stenosis, with lower rates of neurological deficit and cognitive decline. CEA is preferred for most patients.
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Ischemic stroke is a leading cause of long-term disability.
- Carotid stenosis is a significant risk factor for stroke.
- Comparing surgical and endovascular interventions is crucial for stroke prevention.
Purpose of the Study:
- To compare the short-term and mid-term outcomes of carotid endarterectomy (CEA) and carotid artery stenting (CAS).
- To evaluate the efficacy and safety of CEA versus CAS in patients with carotid stenosis.
Main Methods:
- A prospective study involving 300 patients with carotid stenosis.
- 150 patients underwent CEA, and 150 underwent CAS with distal protection.
- Comprehensive pre- and post-operative assessments including neurological exams, imaging (MRI), cognitive tests, and Transcranial Doppler (TCD) monitoring for microembolic signals (MES).
Main Results:
- Zero mortality in both groups.
- CEA group: 1.3% neurological deficit, 4% embolic lesions (MRI), 4% cognitive decline.
- CAS group: 3.3% neurological deficit, 34% embolic lesions (MRI), 25.3% cognitive decline.
- Two myocardial infarctions occurred in the CEA group during follow-up.
Conclusions:
- Carotid endarterectomy (CEA) is the preferred treatment for carotid stenosis, particularly in asymptomatic patients, due to lower morbidity.
- Carotid artery stenting (CAS) is reserved for specific cases like restenosis, post-radiation/surgery, or complex anatomy.
- Further multicenter randomized trials are needed for definitive conclusions.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:14Time Course of Drug Effect
The progression of a drug's impact can be analyzed by examining both the concentration-time course and the effect-time course. The concentration-time course is determined by the drug's half-life and is influenced by factors such as its pharmacokinetics, including absorption, distribution, metabolism, and elimination. The effect of the drug is often related to its concentration in the plasma and is calculated using the maximum drug effect and the plasma concentration that generates 50 percent of...