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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Long-term prognosis after revascularization therapy in patients with atherothrombotic stroke

Ugur Uygunoglu1, Gulcin Benbir, Baki Goksan

  • 1Istanbul University, Cerrahpasa Faculty of Medicine, Department of Neurology, Istanbul, Turkey.

Turkish Neurosurgery
|October 9, 2013
PubMed

Insights

Carotid endarterectomy (CEA) and carotid artery stenting (CAS) showed similar long-term outcomes for stroke patients. Neither procedure demonstrated significant differences in morbidity or mortality, offering comparable treatment options.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiology

Background:

  • Guidelines recommend carotid endarterectomy (CEA) or carotid artery stenting (CAS) for symptomatic carotid stenosis >70%.
  • Evaluating clinical outcomes of CEA versus CAS is crucial for patient management.

Purpose of the Study:

  • To compare the clinical characteristics and long-term outcomes of patients undergoing CEA and CAS.
  • To assess the safety and efficacy of revascularization therapies for carotid stenosis.

Main Methods:

  • Retrospective review of 2369 stroke patients treated since 1996.
  • Analysis of 92 patients who underwent revascularization (41 CEA, 42 CAS, 9 vertebral stenting).
  • Follow-up for a mean of 50.2 months to evaluate recurrent stroke, TIA, myocardial infarction, and mortality.

Main Results:

  • No significant differences in recurrent stroke, TIA, or cerebrovascular deaths between CEA and CAS.
  • Higher incidence of myocardial infarction and cardiovascular deaths in the CAS group (not significant).
  • Increased deaths from other diseases and non-fatal complications in the CEA group.
  • Asymptomatic restenoses were more frequent in the CAS group.

Conclusions:

  • No significant long-term discrepancies in morbidity or mortality were observed between CEA and CAS.
  • Both CEA and CAS represent viable treatment options for selected patients with carotid stenosis.
  • Further research may be needed to explore specific risk factors and long-term event rates.
Abstract

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