title: Short-Term Results of Carotid Endarterectomy and Stenting After the Introduction of Carotid Magnetic Resonance Imaging: A Single-Institution Retrospective Study.
abstract: OBJECTIVE
  Although carotid artery stenting (CAS) has been gaining popularity as an alternative to carotid endarterectomy (CEA), perioperative stroke rate following contemporary CAS remains significantly higher than stroke rate after CEA. The purpose of this study was to assess perioperative (within 30 days) therapeutic results in patients with carotid stenosis (CS) after introduction of preoperative carotid magnetic resonance imaging plaque evaluation in a single center performing both CEA and CAS.
  
  
  METHODS
  Based on prospectively collected data for patients with CS who were scheduled for carotid revascularization, retrospective analysis was conducted of 295 consecutive patients with CS. An intervention was selected after consideration of periprocedural risks for both CEA and CAS. Concerning risk factors for CAS, results of magnetic resonance imaging plaque evaluation were emphasized with a view toward reducing embolic complications.
  
  
  RESULTS
  CAS was performed in 114 patients, and CEA was performed in 181 patients. Comparing baseline characteristics of the 295 patients, age, T1 signal intensity of plaque, symptomatic CS, urgent intervention, and diabetes mellitus differed significantly between CAS and CEA groups. Among patients who underwent CAS, new hyperintense lesions on diffusion-weighted imaging were confirmed in 47 patients. New hyperintense lesions on diffusion-weighted imaging were recognized in 21.4% of patients who underwent CEA (n = 39), significantly less frequent than in patients who underwent CAS.
  
  
  CONCLUSIONS
  The overall short-term outcome of CEA and CAS is acceptable. Preoperative carotid magnetic resonance imaging evaluation of plaque might contribute to low rates of ischemic complications in CAS.
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Fukumitsu
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan. Electronic address: kazuy@kuhp.kyoto-u.ac.jp.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kurosaki
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Torihashi
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Nobutake
authors.initials: N
authors.lastname: Sadamasa
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Masaomi
authors.initials: M
authors.lastname: Koyanagi
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Narumi
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Chin
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Handa
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
authors.forename: Sen
authors.initials: S
authors.lastname: Yamagata
authors.affiliation: Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Miyamoto
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000639:trends*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carotid artery stenting; Carotid endarterectomy; Carotid plaque; Magnetic resonance imaging; Perioperative complication