| Clinical Outcomes Comparing Carotid Endarterectomy and Carotid Artery Stenting in Elderly Patients: An Analysis of Periprocedural Complications for Non-expert Neurosurgeon |
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Han Joo Lee , Chang-Ki Hong , Je Beom Hong , Joonho Chunng , Yong Bae Kim , Jin-Yang Joo |
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Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea |
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| Abstract |
Objective
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) continue to be the standard treatment for carotid artery stenosis. However, it is evident that the operator’s level of expertise has a strong influence on periprocedural complications and clinical outcome. The aim of this study is to review our experience of CEA and CAS performed by the two young neurosurgeons that had same learning periods in a single institute.
Methods
Between August 2007 and May 2012, 46 consecutive patients were treated with CEA, 28 CAS procedures were performed. The mean age of CEA group was 69.62±7.97 (range 59-84) and 69.00±8.33 (range 57-83) years in CAS group. Mean follow-up duration was 14.41±9.11 (range 6-35) and 30.25±7.29 (range 14-44) months for CEA and CAS, respectively. Periprocedural complications were compared between the two treatment groups.
Results
In CEA group, five (10.9%) periprocedural complications were encountered including hypoglossal nerve injury (n=1, 2.2%) and postoperative ischemic stroke (n=1, 2.2%). In CAS group, five (17.9%) complications were occurred during the periprocedural period including in-stent thrombosis (n=1, 3.6%), embolic infarction (n=1, 3.6%), and hyperperfusion syndrome (n=1, 3.6%). One patient (3.6%) in CAS group and one patient (2.2%) in CEA group showed angiographic re-stenosis on follow up (mean=12.0 months) angiography.
Conclusion
In this analysis of our experience of two operators, the periprocedural complications were not significantly different between the CEA and CAS. The effect of the learning curve related to technical expertise may influence the results of treatment. |
| Key Words:
Carotid endarterectomyㆍCarotid artery stentingㆍCarotid artery stenosis |
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