Background
Carotid endarterectomy (CEA) and carotid stenting (CAS) are beneficial procedures
for patients with high-grade cervical carotid stenosis. However, it is sometimes difficult
to manage patients with bilateral carotid stenosis. To decide the treatment strategy,
one of the most important questions is whether contralateral stenosis increases the
risk of patients undergoing CEA.
Methods
This retrospective study included 201 patients with carotid stenosis who underwent
a total of 219 consecutive procedures (CEA 189/CAS 30). We retrospectively analyzed
outcomes in patients with carotid stenosis who were treated with either CEA or CAS
and evaluated whether or not contralateral lesions increases the risk of patients
undergoing CEA or CAS. Furthermore, we retrospectively verified our treatment strategy
for bilateral carotid stenosis.
Results
The incidences of perioperative complications were 5.3% in the CEA patients and 6.7%
in the CAS patients, respectively. There was no significant difference between these
2 groups. The existences of contralateral occlusion and/or contralateral stenosis
were not associated with perioperative complications in both the groups. There were
32 patients with bilateral severe carotid stenosis (>50%). Of those, 13 patients underwent
bilateral revascularizations; CEA followed by CEA in 8, CEA followed by CAS in 3,
CAS followed by CEA + coronary artery bpass grafting in 1, and CAS followed by CAS
in 1.
Conclusions
Our date showed that the existence of contralateral carotid lesion was not associated
with perioperative complications, and most of our cases with bilateral carotid stenosis
initially underwent CEA.
Key Words
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Article info
Publication history
Published online: May 05, 2015
Accepted:
March 31,
2015
Received:
December 10,
2014
Footnotes
There is no conflict of interest to report.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.052
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
