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2015 ; 55
(2
): 124-32
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Selecting an appropriate surgical treatment instead of carotid artery stenting
alone according to the patient s risk factors contributes to reduced
perioperative complications in patients with internal carotid stenosis: a single
institutional retrospective analysis
#MMPMID25746306
Sato K
; Suzuki S
; Yamada M
; Oka H
; Kurata A
; Okamoto H
; Fujii K
; Kumabe T
Neurol Med Chir (Tokyo)
2015[]; 55
(2
): 124-32
PMID25746306
show ga
This retrospective study was aimed to compare the perioperative complications for
internal carotid artery stenosis (ICS) in a Japanese single institute between the
use of carotid artery stenting (CAS) alone or the use of an appropriate
individualized treatment method allowing either carotid endarterectomy (CEA) or
CAS based on patient risk factors. Based on the policy at our hospital, only CAS
was performed on patients (n = 33) between January 2005 and November 2009. From
December 2009 to December 2012, either CEA or CAS (tailored treatment) was
selected for patients (n = 61) based on individual patient risk factors. CEA was
considered the first-line treatment in all cases. In high-risk CEA cases, CAS was
performed instead (n = 11), whereas in low-risk CEA cases, CEA was performed (n =
19). Further, in moderate-risk CEA cases based on own criteria, CAS was
considered first, whereas for high-risk CAS cases, CEA was performed (n = 17).
For low-risk CAS cases, CAS was performed (n = 9). Perioperative clinical
complications (any stroke, myocardial infarction, or death within 30 days) were
compared between both periods. Significantly reduced perioperative complications
were observed during the tailored period (4/61 sites, 6.6%) as compared with the
CAS period (8/33 sites, 24.2%) [Fisher's exact test p = 0.022; odds ratio, 4.56
(CAS/tailored); 95% confidence interval, 1.26-16.5]. Selecting an appropriate
individualized treatment method according to patient risk factors, as opposed to
adhering to a single treatment approach such as CAS, may contribute to improved
overall outcomes in patients with ICS.