Clinical Efficacy Comparison Between Carotid Endarterectomy and Carotid Artery Sten-ting on Extracranial Carotid Stenosis Treatment_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SUNXiao-lei , YUANGang , ZHANGLei , WANGWei-ming , HEHu-qiang , XUXiong-fei , WANGYu-ping , ZENGHong , HEYan-Zheng ,  LIUYong

Department of Vascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China;

Corresponding author：

LIUYong, Email: 13688209071@163.com

Keywords：

Carotid artery stenosis; Carotid endarterectomy; Carotid artery stenting; Clinical efficacy

DOI：

10.7507/1007-9424.20160216

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the clinical efficacy of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in the treatment of patients with carotid artery stenosis, and to provide a more abundant evidence-based medicine for the treatment of CEA and CAS in patients with carotid artery stenosis. Methods Forty patients with carotid artery stenosis were randomly divided into CEA group and CAS group based on the operative indication. Patients in CEA group were given carotid endarterectomy treatment and those in CAS group were given carotid artery stenting treatment. Then clinical efficacy of the two groups were observed and compared. Results In terms of the occurring rate of perioperative complications, cardiovascular events in 3 months after operation, and some major end events such as stroke, death and so on, the comparative difference between the two groups was of no statistical significance (P > 0.05). Through the followed-up visits of 12 months, the comparative difference between the two groups was also of no statistical significance (P > 0.05) in terms of the occurring rate of carotid artery restenosis and disabling or fatal stroke. Conclusions For patients with severe extracranial carotid stenosis under indication of operation treatment, carotid endarterectomy and carotid artery stenting are of equivalent clinical efficacy, and both of them are of high security, although further study with large-amount and evidence-based medical data in long term from multiple centers is still in need.

Citation： SUNXiao-lei, YUANGang, ZHANGLei, WANGWei-ming, HEHu-qiang, XUXiong-fei, WANGYu-ping, ZENGHong, HEYan-Zheng, LIUYong. Clinical Efficacy Comparison Between Carotid Endarterectomy and Carotid Artery Sten-ting on Extracranial Carotid Stenosis Treatment. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(7): 833-837. doi: 10.7507/1007-9424.20160216 Copy

1.	Huang JF, Meschia JF. Interventions for extracranial carotid artery stenosis: an update. Curr Treat Options Cardiovasc Med, 2016, 18(5): 34.
2.	Doig D, Turner EL, Dobson J, et al. Risk factors for stroke, myocar-dial infarction, or death following carotid endarterectomy: results from the international carotid stenting study. Eur J Vasc Endovasc Surg, 2015, 50(6): 688-694.
3.	Dandapat S, Robinson JG. Guidelines for management of hyperlipi-demia: implications for treatment of patients with stroke secondary to atherosclerotic disease. Curr Neurol Neurosci Rep, 2016, 16(3): 24.
4.	Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the american heart association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
5.	Mizukami H, Shimizu T, Maki F, et al. Progression of intracranial major artery stenosis is associated with baseline carotid and intracr-anial atherosclerosis. J Atheroscler Thromb, 2015, 22(2): 183-190.
6.	Lavine SD, Cockroft K, Hoh B, et al. An international multi-society consensus document. AJNR Am J Neuroradiol, 2016, 37(4): E31-E34.
7.	Spence JD, Naylor AR. Endarterectomy, Stenting, or Neither for Asymptomatic Carotid-Artery Stenosis. N Engl J Med, 2016, 374(11): 1087-1088.
8.	Huynh K. Atherosclerosis: carotid artery stenting versus endarterec-tomy-no difference in long-term outcomes. Nat Rev Cardiol, 2014, 11(12): 685.
9.	Boutchakova M, Papanagiotou P. Endovascular treatment of acute extracranial carotid artery occlusion. Radiologe, 2016, 56(1): 18-23.
10.	Featherstone RL, Dobson J, Ederle J, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): a randomised contro-lled trial with cost-effectiveness analysis. Health Technol Assess, 2016, 20(20): 1-94.
11.	Szikra P, Boda K, Rarosi F, et al. Aortic arch and common carotid artery plaques with soft components pose a substantial risk of cerebral embolization during carotid stenting. Interv Neuroradiol, 2016, pii: 1591019916633242. [Epub ahead of print].
12.	Chatzikonstantinou A, Ebert AD, Schoenberg SO, et al. Atheroscle-rosis in intracranial, extracranial, and coronary arteries with aortic plaques in patients with ischemic stroke of undetermined etiology. Int J Neurosci, 2015, 125(9): 663-670.
13.	Mayor S. Carotid artery stenting is as effective as carotid endarterec-tomy, study shows. BMJ, 2016, 352: i1068.
14.	Spence JD, Naylor AR. Endarterectomy, stenting, or neither for asymptomatic carotid-artery stenosis. N Engl J Med, 2016, 374(11): 1087-1088.
15.	Fantozzi C, Taurino M, Rizzo L, et al. Carotid endarterectomy or stenting in octogenarians in a monocentric experience. Ann Vasc Surg, 2016, 33: 132-137.
16.	Howard G, Roubin GS, Jansen O, et al. Association between age and risk of stroke or death fromcarotid endarterectomyandcaroti-dstenting: a meta-analysis of pooled patient data from four rando-mised trials. Lancet, 2016, 387(10025):1305-1311.
17.	Ziaja D, Biolik G, Kocełak P, et al. Neurological symptoms associated with cerebral hyperperfusion syndrome after CEA and CAS-one centre study. Eur Rev Med Pharmacol Sci, 2014, 18(8): 1176-1180.
18.	Brott TG, Howard G, Roubin GS, et al. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med, 2016, 374(11): 1021-1031.
19.	汪忠镐.汪忠镐血管外科学.杭州:浙江科学技术出版社, 2010: 780-787.
20.	Liu CY, Chen CQ. Intra-and extracranial atherosclerotic stenosis in China: epidemiology, diagnosis, treatment and risk factors. Eur Rev Med Pharmacol Sci, 2014, 18(22): 3368-3379.
21.	Sun J, Hatsukami TS. Plaque imaging to decide on optimal treatment: medical versus carotid endarterectomy versus carotid artery stenting. Neuroimaging Clin N Am, 2016, 26(1): 165-173.
22.	Botnar RM, Ebersberger H, Noerenberg D, et al. Molecular imaging in cardiovascular diseases. Rofo, 2015, 36(2): 92-101.
23.	Sun DJ, Zhuang AX, Zeng QH, et al. A study of microemboli moni-toring of atherosclerotic thrombotic cerebral infarction and artery stenosis. Genet Mol Res, 2014, 13(3): 6734-6745.
24.	Ryoo S, Lee MJ, Cha J, et al. Differential vascular pathophysiologic types of intracranial atherosclerotic stroke: a high-resolution wall magnetic resonance imaging study. Stroke, 2015, 46(10): 2815-2821.
25.	Brugge KT. Regarding training guidelines for endovascular ischemic stroke intervention. Interv Neuroradiol, 2016, 22(3): 253.

1. Huang JF, Meschia JF. Interventions for extracranial carotid artery stenosis: an update. Curr Treat Options Cardiovasc Med, 2016, 18(5): 34.
2. Doig D, Turner EL, Dobson J, et al. Risk factors for stroke, myocar-dial infarction, or death following carotid endarterectomy: results from the international carotid stenting study. Eur J Vasc Endovasc Surg, 2015, 50(6): 688-694.
3. Dandapat S, Robinson JG. Guidelines for management of hyperlipi-demia: implications for treatment of patients with stroke secondary to atherosclerotic disease. Curr Neurol Neurosci Rep, 2016, 16(3): 24.
4. Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the american heart association/American Stroke Association. Stroke, 2016, 47(6): e98-e169.
5. Mizukami H, Shimizu T, Maki F, et al. Progression of intracranial major artery stenosis is associated with baseline carotid and intracr-anial atherosclerosis. J Atheroscler Thromb, 2015, 22(2): 183-190.
6. Lavine SD, Cockroft K, Hoh B, et al. An international multi-society consensus document. AJNR Am J Neuroradiol, 2016, 37(4): E31-E34.
7. Spence JD, Naylor AR. Endarterectomy, Stenting, or Neither for Asymptomatic Carotid-Artery Stenosis. N Engl J Med, 2016, 374(11): 1087-1088.
8. Huynh K. Atherosclerosis: carotid artery stenting versus endarterec-tomy-no difference in long-term outcomes. Nat Rev Cardiol, 2014, 11(12): 685.
9. Boutchakova M, Papanagiotou P. Endovascular treatment of acute extracranial carotid artery occlusion. Radiologe, 2016, 56(1): 18-23.
10. Featherstone RL, Dobson J, Ederle J, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): a randomised contro-lled trial with cost-effectiveness analysis. Health Technol Assess, 2016, 20(20): 1-94.
11. Szikra P, Boda K, Rarosi F, et al. Aortic arch and common carotid artery plaques with soft components pose a substantial risk of cerebral embolization during carotid stenting. Interv Neuroradiol, 2016, pii: 1591019916633242. [Epub ahead of print].
12. Chatzikonstantinou A, Ebert AD, Schoenberg SO, et al. Atheroscle-rosis in intracranial, extracranial, and coronary arteries with aortic plaques in patients with ischemic stroke of undetermined etiology. Int J Neurosci, 2015, 125(9): 663-670.
13. Mayor S. Carotid artery stenting is as effective as carotid endarterec-tomy, study shows. BMJ, 2016, 352: i1068.
14. Spence JD, Naylor AR. Endarterectomy, stenting, or neither for asymptomatic carotid-artery stenosis. N Engl J Med, 2016, 374(11): 1087-1088.
15. Fantozzi C, Taurino M, Rizzo L, et al. Carotid endarterectomy or stenting in octogenarians in a monocentric experience. Ann Vasc Surg, 2016, 33: 132-137.
16. Howard G, Roubin GS, Jansen O, et al. Association between age and risk of stroke or death fromcarotid endarterectomyandcaroti-dstenting: a meta-analysis of pooled patient data from four rando-mised trials. Lancet, 2016, 387(10025):1305-1311.
17. Ziaja D, Biolik G, Kocełak P, et al. Neurological symptoms associated with cerebral hyperperfusion syndrome after CEA and CAS-one centre study. Eur Rev Med Pharmacol Sci, 2014, 18(8): 1176-1180.
18. Brott TG, Howard G, Roubin GS, et al. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med, 2016, 374(11): 1021-1031.
19. 汪忠镐.汪忠镐血管外科学.杭州:浙江科学技术出版社, 2010: 780-787.
20. Liu CY, Chen CQ. Intra-and extracranial atherosclerotic stenosis in China: epidemiology, diagnosis, treatment and risk factors. Eur Rev Med Pharmacol Sci, 2014, 18(22): 3368-3379.
21. Sun J, Hatsukami TS. Plaque imaging to decide on optimal treatment: medical versus carotid endarterectomy versus carotid artery stenting. Neuroimaging Clin N Am, 2016, 26(1): 165-173.
22. Botnar RM, Ebersberger H, Noerenberg D, et al. Molecular imaging in cardiovascular diseases. Rofo, 2015, 36(2): 92-101.
23. Sun DJ, Zhuang AX, Zeng QH, et al. A study of microemboli moni-toring of atherosclerotic thrombotic cerebral infarction and artery stenosis. Genet Mol Res, 2014, 13(3): 6734-6745.
24. Ryoo S, Lee MJ, Cha J, et al. Differential vascular pathophysiologic types of intracranial atherosclerotic stroke: a high-resolution wall magnetic resonance imaging study. Stroke, 2015, 46(10): 2815-2821.
25. Brugge KT. Regarding training guidelines for endovascular ischemic stroke intervention. Interv Neuroradiol, 2016, 22(3): 253.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Efficacy Comparison Between Carotid Endarterectomy and Carotid Artery Sten-ting on Extracranial Carotid Stenosis Treatment

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content