Clinical study of carotid endarterectomy and carotid artery stenting in treating carotid artery stenosis in the elderly

Abstract

Objective To investigate the clinical efficacy and safety of carotid endarterectomy(CEA)and carotid artery stenting(CAS)for the treatment of carotid artery stenosis in the elderly. Methods Clinical data of 116 elderly patients aged over 65 years with carotid artery stenosis were retrospectively analyzed.Of 116 patients, 73 patients underwent CAS(the CAS group)and 32 received CEA(the CEA group). The success rate, 30-day perioperative complications and follow-up results were compared between the two groups. Results There was no significant difference in the success rate(96.8% vs.100.0%, P>0.05), 30-day perioperative complications, such as bradycardia(6.25% vs.4.5%, χ2=0.228, P=0.663), acute myocardial infarction(0.0 vs.1.4%, χ2=0.432, P=0.511), transient hypotension(6.3% vs.8.1%, χ2=0.114, P=0.735), ischemic stroke(6.3% vs.6.8%, χ2=0.009, P=0.923), and cerebral hyperperfusion syndrome(18.8% vs.10.8%, χ2=0.009, P=0.923), between the CEA and CAS groups.The incidence of persistent hypotension was lower in the CEA group than in the CAS group(3.1% vs.17.6%, χ2=4.398, P=0.036). No significant difference was found in carotid artery restenosis(moderate: 6.3% vs.8.1%, χ2=0.114, P=0.735; severe: 3.1% vs.2.7%, χ2=0.014, P=0.905)and ipsilateral stroke(3.1% vs.5.4%, χ2=0.279, P=0.598)between the CEA and CAS groups at one-year fellow-up. Conclusions Both CEA and CAS have good efficacies in treating carotid artery stenosis in the elderly, while the incidence of persistent hypotension is higher with CAS than with CEA. Key words: Carotid stenosis; Stents; Endarterectomy carotid