Document Detail

Stenting Carotideo e Endoarterectomia Carotidea Esperienza di un singolo Centro.
MedLine Citation:
PMID:  22759467     Owner:  NLM     Status:  In-Data-Review    
AIM: 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.
MATERIALS: 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.
DISCUSSION: 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. KEY WORDS: Carotid Endoarterectomy, Carotid Angioplasty, Carotid Stenosis, Ictus Cerebri.
Francesca Frezzotti; Leslie Fiengo; Federico Bucci; Christian Brogna; Rita Mele; Adriano Redler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annali italiani di chirurgia     Volume:  83     ISSN:  0003-469X     ISO Abbreviation:  Ann Ital Chir     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372343     Medline TA:  Ann Ital Chir     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  291-6     Citation Subset:  IM    
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