Carotid artery stenting in a single center: are six years of experience enough to achieve the standard of care?
OBJECTIVE
This study aims to determine safety, short and mid-term outcomes of Carotid Artery Stenting (CAS) and Endarterectomy (CEA) during the last 6 years in a single vascular surgery center.


METHODS
We retrospectively reviewed 2624 consecutive carotid revascularizations performed between December 2000 and December 2006 in 2176 patients with severe carotid artery stenosis (symptomatic > or = 70%, asymptomatic > or = 80%), of which 1589 were CEA and 1035 CAS. Patients were followed up at 1, 3, 6 and 12 months after the procedure and then yearly.


RESULTS
The percutaneous procedure was successful in 99.2% of the cases. No intra-procedural death occurred. The overall death and stroke rates at 30 days, 1 year and 3 years were 1.54%, 2.86%, 7.43% in the CAS group and 2.07%, 3.55%, 6.95% in the CEA group, respectively (p value not significant in any case).


CONCLUSIONS
At our vascular surgery centre the results of CEA and CAS are similar. CAS has become our standard of care in preventing strokes and is an effective alternative to CEA for low-risk patients as well.
Setacci
C
C
Department of Surgery, Vascular and Endovascular Surgery Unit, University of Siena, Viale Bracci, I-53100 Siena, Italy. setacci@unisi.it
Chisci
E
E
de Donato
G
G
Setacci
F
F
Sirignano
P
P
Galzerano
G
G
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000592:standards*; D016893:Carotid Stenosis / Q000628:therapy*; D002423:Cause of Death; D018572:Disease-Free Survival; D016894:Endarterectomy, Carotid / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000401:mortality; D007558:Italy; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D019984:Quality Indicators, Health Care / Q000592:standards*; D015607:Stents / Q000592:standards*; D020521:Stroke / Q000209:etiology / Q000401:mortality