Which is worthy to be adopted, carotid endarterectomy or carotid stenting for treatment of symptomatic carotid artery stenosis?

Abu Elfadle, Amr Said; Elghareeb, Mohammed; Ghweeba, Mohamed; SAKR, MOHAMAD ABDELFAATH; Soliman, Ahmed Y

doi:10.21608/muj.2022.158255.1113

Which is worthy to be adopted, carotid endarterectomy or carotid stenting for treatment of symptomatic carotid artery stenosis?

Document Type : Original Article

Authors

¹ Neurosurgery department, Faculty of medicine, Port said university, Egypt

² Neurosurgery Department, Faculty of medicine, South valley university, Qena , Egypt

³ department of surgery, faculty of medicine, port-said university, port-said, Egypt

⁴ Neurology Department, Faculty of medicine, Misr University for science and technology

⁵ Neurosurgery department, Faculty of medicine, Tanta university, Egypt

10.21608/muj.2022.158255.1113

Abstract

Carotid endarterectomy (CEA) has shown a valuable role in preventing stroke in symptomatic patients. However, it is limited by the presence of high-risk medical comorbidities. Alternatively, carotid artery stenting (CAS) has evolved as a less invasive therapeutic modality.
Objective: compare the outcomes of carotid endarterectomy and carotid artery stenting in patients with symptomatic carotid artery stenosis.
Methods: 37 adult patients with symptomatic carotid artery stenosis who were scheduled for either CAS (N=20) or CEA (N=17). Carotid artery assessment via carotid duplex was recorded. The primary endpoint of the study was the incidence of stroke or myocardial infarction within 30-days, and the incidence of death, stroke, or myocardial infarction at 1-year. The secondary endpoints included cranial nerve injury, restenosis, vessel maturation, intracranial hemorrhage, and any complications at the surgical site within 30 days.
Results: Within 30 days of the procedures, the incidence of stroke or transient ischemic attack was 20.0% in the CAS group compared with 17.6% in the CEA group . Myocardial infarction did not ensue in either group. None of the patients in the CAS group developed cranial nerve injury compared to two patients in the CEA group. The incidence of local hematoma was lower in the CAS group (5.0%) than in the CEA group (29.4%). A 1-year follow-up, equal death, and stroke rates in the CAS and CEA groups were 10.0% versus 11.8%.
Conclusions: The findings of the present study indicate comparable results within 30 days and at 1-year follow-up among patients who underwent CAS or CEA.

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