title: [Stenting versus carotid endarterectomy for carotid stenosis. A single center experience].
abstract: OBJECTIVE
  The objective was to compare Carotid Endarterectomy (CEA) with Carotid Artery Stenting (CAS) in terms of efficacy and safety in patients with symptomatic and asymptomatic extracranial carotid stenosis.
  
  
  METHODS
  This study enrolled 285 patients with symptomatic and asymptomatic carotid stenosis that underwent either to CAS or CEA. The primary end-points were death, stroke and myocardial infarction. The secondary end-points were restenosis and nerve injury. The Data emerged from the follow-up at 1,3,6,12,24 months that provided for clinical and EcocolorDoppler monitoring. A separate analyse was performed evaluating the prediction of the Ultrasonographic appearance of the atheroma on the symptomatic nature of the lesion.
  
  
  RESULTS
  The percentage of neurological symptomatology in the periprocedural period was higher in CAS than in CEA group (9% vs 3%). We didn't report any case of periprocedural death. The results from the follow-up are: myocardial infarction 5% CAS vs 7% CEA; stroke 5% CAS vs 4% CEA; restenosis 3% CAS vs 6% CEA; nerve injury 0% CAS vs 1% CEA; mortality 0% CAS vs 1% CEA.
  
  
  CONCLUSIONS
  CEA is the gold standard for treatment of significant carotid stenosis, although endovascular technique is emerging as a less invasive alternative. CAS has presented a less frequence of myocardial infarction, nerve injury and long-term mortality, but it showed an higher percentage of neurological events both in short and long-term. This last aspect is correlated with the plaque structure. Ultrasonographic study of the atheroma has become a defining moment in the choice of the therapeutic strategy.
authors: Dipartimento di Sciennze Chirurgiche, Universita degli Studi, La Sapienza di Roma, Italy.
authors: Francesca
authors: F
authors: Frezzotti
authors: Leslie
authors: L
authors: Fiengo
authors: Federico
authors: F
authors: Bucci
authors: Christian
authors: C
authors: Brogna
authors: Rita
authors: R
authors: Mele
authors: Adriano
authors: A
authors: Redler
mesh_terms: D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents