Comparing Carotid Artery Stenting and Carotid Endarterectomy in Symptomatic and Asymptomatic Carotid Stenosis

Abstract

Objective: In patients with symptomatic and asymptomatic carotid artery stenosis, this retrospective observational
study compared the clinical outcomes and side effects of carotid endarterectomy (CEA) with carotid artery stenting (CAS). The study took patient-specific risk variables into account and concentrated on major adverse cardiovascular events (MACE), such as myocardial infarction (MI), stroke, readmission, and death.
Material and Method: This was a retrospective observational study carried out at Vascular Surgery Department and Interventional Radiology department of two tertiary care hospitals in Rawalpindi, from Jan 2022 to March 2023. With a 30-day follow-up, 60 patients from two Pakistani tertiary care centres underwent either carotid end arterectomy and carotid artery stenting were included. Patient having asymptomatic and symptomatic carotid disease were selected for the procedure. The impact of risk factors on procedural success and development of major adverse cardiovascular events (MACE) was examined in the study. Data regarding 30-day postoperative parameters of the procedure were collected and evaluated. p< 0.05 is considered significant.
Results: The majority of patients in our series were males 46(77%) compared to 14(23%) females in the study. There were no intraoperative mortalities in our patients. The mortality rate of CAS alone was 1(1.66%). Four patients developed complications. Three in CAS group and 1 in CEA group. Comorbidities were present in 46(77%).
Conclusion: Compared to CEA, CAS is linked to a greater risk of stroke or mortality in patients with symptomatic carotid stenosis within 30 days of treatment. Patients' unique characteristics, age, comorbidities, and previous surgical experiences should guide the choice of treatment.