Revascularization of carotid circulation with carotid stenting and endarterectomy

DOI: https://doi.org/10.25512/DIR.2017.11.2.06

For quoting:
Stolyarov D.P., Sakhnov E.V., Melnikov A.V., Andin A.V., Kolosova S.A., Tovbis E.S., Valik O.V., Sakovich V.A. "Revascularization of carotid circulation with carotid stenting and endarterectomy". Journal Diagnostic & interventional radiology. 2017; 11(2); 53-60.

authors:

Stolyarov D.P.

Sakhnov E.V.

Melnikov A.V.

Andin A.V.

Kolosova S.A.

Tovbis E.S.

Valik O.V.

Sakovich V.A.

keywords:

carotid stenting

carotid endarterectomy

carotid artery stenosis

ischemic stroke

Abstract:

Aim: was to estimate efficacy and safety of carotid stenting and carotid endarterectomy Г patients, admitted to center of cardiovascular surgery.

Material and methods: we investigated possibilities of treatment with randomization one-by-one, according to admittance to hospital and use of carotid endarterectomy or stenting. Final decision in each case was made by consilium. For the period 2011-2013, 269 patients were treated including 132 patients who underwent carotid endarterectomy and 137 patients who underwent carotid stenting. The majority of patients had an anamnesis of coronary heart disease or needed coronary revascularization. Symptomatic stenosis was an indication for 19,0 % revascularization in both groups (p = 0.994).

Results: there were no in-hospital deaths registered. Incidence of stroke after carotid endarterectomy was 6(4,5%) and 2(1,5%) after stenting. Transient ischemic attack occurred in 3(2,2 %) patients in the stenting and 1 patient (0,76 %) in endarterectomy groups. Major bleeding was observed in both groups with equal frequency (p = 0,584). Defeat of cranial nerves (7,6 %; p = 0,001) was only observed in the endarterectomy group. Finally both methods of carotid revascularization showed the same level of complications (p = 0,569) besides cranial nerve defeat.

Conclusion: carotid stenting and endarterectomy show similar results in the treatment of patients with atherosclerotic lesions of carotid arteries. Both methods can equally be used in clinics with adequate experience in surgical interventions on the heart and peripheral vessels. The complex assessment of the patient and the lesion by the vascular team is necessary.

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