Severe stenosis and more severe stenosis of carotid artery: treatment strategies and complications

doi:10.16139/j.1007-9610.2019.04.009

Abstract

Abstract: Objective To compare the efficacy and complications of carotid endarterectomy (CEA) with carotid sten-ting (CAS) in treatment of patients with severe carotid artery stenosis from 70% to 90% and more severe stenosis >90%. Methods The clinical data of 463 patients with carotid stenosis 70% and more who underwent surgical treatment from January 2015 to December 2017 at Changhai Hospital were retrospectively analyzed. Results There were 202 patients with severe carotid stenosis from 70% to 90% including 62 cases in CEA group and 140 cases in CAS group and no significant difference was present in the incidence of postoperative recurrent stroke between two groups (3.2% vs 6.7%, P=0.181). Restenosis was found 2.2% in CAS group and none in CEA group(P=0.240). Patients with tongue deviation (4.8%) and speech function disorder(3.2%) were found in CEA group and none in CAS group(P=0.009, P=0.033). There were 261 cases with more severe stenosis >90% including 95 cases in CEA group and 166 cases in CAS group. There was no significant difference in the incidence of recurrent stroke between two groups (P=0.135) with 1.1% in CEA group and 4.5% in CAS group respectively. The incidence of restenosis in CAS group was 5.7% and none in CEA group (P=0.017). The occurrence of tongue deviation and speech function disorder in CEA group were 4.2% and 3.2% respectively, and none in CAS group (P=0.008, P=0.021). Conclusions The result of treatment using CEA or CAS was similar for patients with severe carotid stenosis, with no postoperative nervous complication in CAS group. However, the effect of CEA was better than CAS for the patients with more severe carotid stenosis.

Key words: Carotid stenosis, Severe, Carotid endarterectomy, Carotid artery stent, Complication

CLC Number:

R654.3

HAN Tonglei, WANG Shiying, SUN Yudong, WEI Xiaolong, ZHU Jiang, LU Minhao, ZHAO Bin, ZHAO Zhiqing, JING Zaiping. Severe stenosis and more severe stenosis of carotid artery: treatment strategies and complications[J]. Journal of Surgery Concepts & Practice, 2019, 24(04): 315-319.

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