CAR 12. Trends and Outcomes of Carotid Revascularization in the Chinese Population: Analysis of >1000 Cases in a Single Institution from 2002 to 2017

Abstract

Vast and profound changes have taken place in China during the past 3 decades. Stroke burden remains particularly high in this country, with an incidence and mortality rate of 246.8 and 114.8/100,000 people, respectively. However, the efficacy and safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in the Chinese population are not clear. In this study, we investigated the outcomes after carotid revascularization for Chinese patients in a single institution. This observational study retrospectively analyzed 1175 hospitalized carotid stenosis patients (mean age, 68.12 ± 17.7 years; 82.33% male; 61.28% symptomatic) from 2002 to 2017 in Huashan Hospital, Fudan University, Shanghai. During these 17 years, the number of CEA procedures (753 cases) grew steadily; the proportion of CEA using shunt and patch was 91.37%. The CAS procedures (422 cases) increased significantly since 2007; the proportion of CAS with an embolic protection device was nearly 100% since 2011. The 30-day complication rates after CEA and CAS were 2.52% vs 7.14% (P < 0.01) for death and stroke, 6.37% vs 1.29% (P < .01) for cranial nerve injuries, and 4.38% vs 2.74% (not significant) for heart complications. In our single-center study, CEA appeared to be effective and safe in treating the carotid artery stenosis that leads to stroke in the Chinese population. A clinical guideline on the management of Chinese patients with extracranial carotid artery disease based on large-scale epidemiologic and clinical investigation is needed to further improve the result of the stroke prevention project launched by the National Health Commission.