Stenting Carotideo e Endoarterectomia Carotidea Esperienza di un singolo Centro

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Francesca Frezzotti, Leslie Fiengo, Federico Bucci, Christian Brogna, Rita Mele, Adriano Redler

Abstract

AIM: The objective was to compare Carotid Endarterectomy (CEA) with Carotid Artery Stenting (CAS) in terms of efficacy and safety in patients with symptomatic and asymptomatic extracranial carotid stenosis.


MATERIALS: This study enrolled 285 patients with symptomatic and asymptomatic carotid stenosis that underwent either to CAS or CEA. The primary end-points were death, stroke and myocardial infarction. The secondary end-points were restenosis and nerve injury. The Data emerged from the follow-up at 1,3,6,12,24 months that provided for clinical and EcocolorDoppler monitoring. A separate analyse was performed evaluating the prediction of the Ultrasonographic appearance of the atheroma on the symptomatic nature of the lesion.


RESULTS: The percentage of neurological symptomatology in the periprocedural period was higher in CAS than in CEA group (9% vs 3%). We didn’t report any case of periprocedural death. The results from the follow-up are: myocardial infarction 5% CAS vs 7% CEA; stroke 5% CAS vs 4% CEA; restenosis 3% CAS vs 6% CEA; nerve injury 0% CAS vs 1% CEA; mortality 0% CAS vs 1% CEA.


DISCUSSION: CEA is the gold standard for treatment of significant carotid stenosis, although endovascular technique is emerging as a less invasive alternative. CAS has presented a less frequence of myocardial infarction, nerve injury and long-term mortality, but it showed an higher percentage of neurological events both in short and long-term. This last aspect is correlated with the plaque structure. Ultrasonographic study of the atheroma has become a defining moment in the choice of the therapeutic strategy.

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How to Cite
Francesca Frezzotti, Leslie Fiengo, Federico Bucci, Christian Brogna, Rita Mele, Adriano Redler. “Stenting Carotideo E Endoarterectomia Carotidea Esperienza Di Un Singolo Centro”. Annali Italiani Di Chirurgia, vol. 83, no. 4, July 2012, pp. 291-6, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2846.
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