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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Intrapatient comparison of restenosis between carotid artery angioplasty with stenting and carotid endarterectomy VASCULAR SECTION
The Journal of Cardiovascular Surgery 2006 Febbraio;47(1):49-54
Intrapatient comparison of restenosis between carotid artery angioplasty with stenting and carotid endarterectomy
De Borst G. J. 1, Hellings W. E. 1, Ackerstaff R. G. A. 2, Moll F. L. 1
1 Department of Vascular Surgery University Medical Center Utrecht Utrecht, The Netherlands
2 Department of Clinical Neurophysiology St. Antonius Hospital Nieuwegein (Utrecht), The Netherlands
Aim. Comparison of restenosis in patients who underwent both carotid artery angioplasty with stenting (CAS) and contralateral carotid endarterectomy (CEA).
Methods. From our CAS data registry (1998-present) all patients with a history of contralateral CEA at any other time were selected (n = 63). Mean age was 70.6, SD=6.8 for CAS and 68.2, SD=6.1 for CEA and symptomatic carotid artery stenosis was present in 24% of patients pre-CAS and 40% pre-CEA. All CEAs were primary interventions, 19% of CAS were secondary to restenosis after previous ipsilateral CEA. All patients were followed up prospectively with duplex at 1 year (CAS: n=58, CEA: n=59), 2 years (CAS: n=44, CEA: n=53), 3 years (CAS: n=27, CEA: n=41), and every year thereafter. Within each patient we compared restenosis (>50%) between CAS and CEA procedures.
Results. After a follow-up of 28.7 months for CAS (SD=16.9) and 54.4 months for CEA (SD=39.5) the rate of ≥ 50% restenosis for CAS vs CEA at 1, 2, and 3 years was 23% vs 10%; 31% vs 19%; and 34 vs 24%, respectively (log rank P=NS).
Conclusion. Our intrapatient comparison of patients who underwent both CAS and contralateral CEA did not reveal significant difference in restenosis between both procedures.