Bölgesel Anestezi Altında Karotis Endarterektomi ile Karotis Arter Stentin Karşılaştırmalı Sonuçları: Retrospektif Analiz ve Literatürün Gözden Geçirilmesi

Abstract

Carotid artery endarterectomy has already gained acceptance as the standard method for treating extracranial carotid artery stenosis. The last 2 decades have witnessed the increasing popularity of minimally invasive endovascular techniques. Patients and Methods: This study involved a retrospective analysis of 41 patients undergoing stent placement in carotid artery and carotid artery endarterectomy between January 2005 and January 2012 due to carotid artery stenosis. The patients were divided into two groups, group 1 (surgery, n=20) and group 2 (stenting, n=21). The two groups were compared with respect to complications, length of hospitalization, and costs. Results: The mean age was 68.35±8.21 years in group 1 and 66.76±9.16 years in group 2. The mean total cost was 2158.00±801.30 TL (Turkish Lira) for group 1 and 6927.86±2884.72 TL for group 2. The mean length of follow-up was 560.05±232.94/ days in the stenting group and was 933.85±505.45 /days in the surgery group. No statistically significant difference was found between the two groups in terms of age, gender, diabetes mellitus, restenosis, mean duration of hospitalization, and mortality (p>0.05). The only difference was observed in the average cost, which turned out to be lower in group 1 than in group 2 (p<0.05). Conclusion:Recently, new alternative stent and filter types have become available, preferred especially in patients with recurrent internal carotid artery stenosis and in those with a history of radiotherapy on the neck. However, when compared with carotid endarterectomy under regional anesthesia is just as safe as stenting and it is also cheaper.