Outcomes Following Carotid Endarterectomy and Carotid Artery Stenting in Patients with Carotid Artery Stenosis: A Retrospective Study from a Single Center in South Korea

초록

Background: Previous randomized controlled trials and meta-analyses comparing carotid endarterectomy (CEA) and carot-id artery stenting (CAS) included a large number of patients, but the diagnosis, treatment selection, and per-formance were heterogeneous. This retrospective study from a single center in South Korea aimed to evaluate outcomes following CEA and CAS in patients with carotid artery stenosis.Material/Methods: A retrospective analysis was performed using the data of patients who underwent carotid revascularization between September 2016 and June 2021 at a single institution. The primary outcomes were stroke, myocardi-al infarction (MI), and death during the periprocedural period.Results: We enrolled a total of 61 (44 symptomatic and 17 asymptomatic) patients who underwent CEA or CAS. Among them, 36 (59%) underwent CEA and 25 (41%) underwent CAS. Statistically significant differences were found between the groups in degree of carotid stenosis (CEA: 87.0 +/- 9.1, CAS: 80.5 +/- 9.3, P=0.007). All patients with con-firmed plaque ulceration before carotid revascularization underwent CEA. Two (3.3%) periprocedural strokes occurred, 1 in each group, on the ipsilateral side. There were no significant differences between CEA and CAS in the event-free survival rate for stroke during the follow-up (log-rank test=0.806).Conclusions: Favorable outcomes in terms of periprocedural stroke were observed. We found no significant difference be-tween the 2 carotid revascularization techniques in the incidence of periprocedural stroke in symptomatic and asymptomatic patients. To confirm our findings, further studies involving a larger number of patients and con-tinuous follow-up are necessary.

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