Preliminary report of carotid endarterectomy versus stenting treatment in patients with severe symptomatic carotid stenosis

Abstract

Objective To compare stenting treatment with endarterectomy in patients with symptomatic carotid stenosis (at least 60％ ).Methods We conducted a center randomized controlled noninferiority trial for comparing stenting treatment to endarterectomy in 195 patients with severe symptomatic atherosclerotic carotid artery stenosis.The primary end point of this hospital - based study was ipsiateral ischaemic stroke or death from time of randomisaion to 90 days after the proceduce.The secondary end point was the related complications of either intervention,or severe restenosis at 90 day after operation.Results 195 patient were induded in the analysis.The rate of death or ipsiateral ischaemic stroke frow randomization to 90 days after stenting procedure was 3.1％ and 3.1％ after carotid endarterectomy.The one - sided p value for non - inferiority is 0.08.The secondary end point occurred in 8 patients randomly assigned to undergo endarterectomy (cumulative incidence,8.3％ ) and 5 patients randomly assigned to undergo stenting (cumulative in cadence,5.1％ ).The difference was not significant.Cranial - nerve injury was more commonly seen after endarterectomy than that after stenting.Conclusions There is no difference in the risks of stenting treatment compared with carotid endarterectomy.The risk of stroke or death after 90 days of treatment is almost identical in both groups. Key words: Endarterectomy; Angioplasty; Randomized controlled trials; Carotid stenosis