Comparison of Mid-, and Late- Term Morbidity and Mortality Results of Surgical Endarterectomy Versus Endovascular Stent Implantation in Carotid Artery Stenosis

Abstract

Objective: Carotid artery stenosis is an important etiological cause of cerebrovascular events and stent implantation is widely used as an alternative treatment to endarterectomy. In this study, we compared the mid and late-term results of carotid artery stenosis patients who underwent endarterectomy and stent implantation. Methods: Patients who underwent endarterectomy (Group A, n: 27) and endovascular stent implantation (Group B, n: 22) due to carotid artery stenosis between 2008 and 2014 were included in the study. All examination, laboratory data and radiological images were collected from the hospital database. Morbidity and mortality developed in the mid (1-12 months) and late term (>12 months) periods were evaluated retrospectively. Results: While there were no neurological complications and restenosis in the midterm in Group A, 2 patients (9.09%) had stroke and 2 patients (9.09%) had restenosis in Group B. In the late-term, while there were no neurological complications in Group A, stroke in 3 patients (13.63%) (p=0.048) in Group B, restenosis was observed in 1 patient in Group A and 5 patients in Group B (3.7% vs 22.72%, p=0.043). Conclusion: We recommend endarterectomy as the primary approach for carotid artery revascularization and percutaneous approach especially in high-risk patients with recurrent ICA stenosis and distal carotid artery lesions.

Management of Deep Bradycardia and Hypotension Developed During Carotid Artery Stenting: A Case Report

“…KAS tekniğinin daha az invaziv bir yöntem olması sebebi ile; inme, akut miyokard enfarktüsü, pulmoner tromboemboli, kranial sinirlerin paralizisi gibi ciddi komplikasyonlar ve mortalite insidansları daha düşük olarak bildirilmektedir. Aynı zamanda hastanede yatış süresinin kısalması gibi avantajlara da sahip olduğu görünmektedir (1,2). Bu olgu sunumunda İKA stenozu stentleme tedavisi yapılan bir hastada perioperatif gelişen derin bradikardiye dikkati çekerek, benzer durumlarda uygulanabilecek yaklaşımları tartışmayı amaçladık.…”