Intrapatient comparison of restenosis between carotid artery angioplasty with stenting and carotid endarterectomy  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2006 February;47(1):49-54

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.