[Carotid endarterectomy and carotid stenting. A pilot study of a prospective, randomized and controlled comparison].
BACKGROUND
A prospective, randomized and controlled trial is conducted to compare carotid endarterectomy and carotid stenting in high grade symptomatic carotid artery stenoses.


METHODS
According to the study design symptomatic patients with a angiographically high-grade (> or = 70%) internal carotid artery stenosis are included. Pre- and postinterventional diagnostics during the hospitalization period includes neurological assessment, duplex sonography of the cervical and cerebral arteries and magnetic resonance imaging of the brain. Follow-up examinations are scheduled after 1, 6 and 12 months and consist of a neurological assessment and duplex sonography. After 12 months selective angiography and magnetic resonance imaging of the brain will be performed additionally. During a period of 9 months up to now 23/137 patients treated for a carotid artery stenosis were included in the study, 11 patients underwent surgery and 12 patients carotid stenting.


RESULTS
Carotid stenting and endarterectomy was primarily successful without residual stenosis > 30% in each patient without the occurrence of stroke or death. In 18 follow-up examinations (neurological assessment including duplex sonography) of 13 patients (13 follow-up examinations after 30 days, 5 after 6 months) no relevant restenosis and no stroke occurred.


CONCLUSIONS
As of yet, carotid stenting was a safe procedure. Due to the small number of patients a definitive conclusion can not be drawn.
Link
J
J
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg.
Manke
C
C
Rosin
L
L
Borisch
I
I
Töpel
I
I
Horn
M
M
Mann
S
S
Jauch
K W
KW
Bogdahn
U
U
Feuerbach
S
S
Kasprzak
P
P
D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000628:therapy; D016894:Endarterectomy, Carotid; D005500:Follow-Up Studies; D006801:Humans; D018579:Patient Selection; D010865:Pilot Projects; D011292:Premedication; D011446:Prospective Studies; D015607:Stents