Long-term results of carotid endarterectomy and carotid stenting.
BACKGROUND
We report the long-term results of surgery for carotid stenosis in our institute, and suggest a better treatment strategy for high-risk patients.


METHODS
Our series of 352 carotid surgeries conducted between April 1998 and May 2007 were investigated. CEA comprised 134 (38%), whereas CAS comprised 218 (62%). In August 2007, we sent questionnaires to all patients, and analyzed responses up to May 2008. For patients undergoing regular follow-up, the data were gathered from the medical records. The questions were: (1) mRS at that time, (2) the cause of death if the patient was deceased, (3) newly diagnosed stroke, and (4) newly diagnosed coronary heart disease.


RESULTS
The response rate was 68.8%. The average follow-up period was 31.2 months. The average differences in mRS pre- and postoperation were -0.33 and -0.48 in CEA and CAS, respectively. The mortality rate at >30days was 8.2% in CEA, and 5.0% in CAS. The leading cause of death was heart disease (31.8%).


CONCLUSIONS
Our report suggests that CAS is not inferior to CEA, and both procedures can be managed safely if all characteristics of the carotid lesions are considered.
Ogata
Hideki
H
Department of Neurosurgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fushimi-kuFushimi-ku, Kyoto 612-8555, Japan. hogata@kyotolan.hosp.go.jp
Tsukahara
Tetsuya
T
Hatano
Taketo
T
Nakakuki
Takuya
T
Murakami
Mamoru
M
Aoyama
Takako
T
Miyakoshi
Akinori
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies