Journal «Angiology and Vascular Surgery» • 

2012 • VOLUME 18 • №1

Outcomes of carotid endarterectomy and stenting in patients with carotid artery stenosis

Gavrilenko A.V.1, Ivanov V.A.2, Piven A.V.1, Kuklin A.V.1, Kravchenko A.A.1, Miklashevich E.R.2, Abugov S.A.1

1) B.V. Petrovsky Russian Research Centre of Surgery under the Russian Academy of Medical Sciences, Moscow, Russia
2) Federal State Facility «3rd Central Military Clinical Hospital named after A.A. Vishnevsky of the Ministry of Defence of the Russian Federation», city of Krasnogorsk, Russia

Analysed in the article are the outcomes of treating a total of 156 patients diagnosed with carotid artery stenosis. Of these, carotid endarterectomy was performed in 82 patients and stenting of carotid arteries was carried out in the remaining 74 patients. The incidence rate of perioperative stroke in the carotid endarterectomy group amounted to 3.6%, being in the stenting group 4.8%, P=0.57. Multifactorial analysis was used to reveal risk factors for each method. Thus, in the carotid endarterectomy group, the risk factors for cerebrovascular complications appeared to be contralateral occlusion in patients with a history of stroke endured within less than six previous months (P<0.05), as well as the age over 75 years amongst the patients requiring placement of a temporary intraluminal bypass graft (P<0.05). For carotid stenting, risk factors of cerebrovascular complications included a hypoechogenic heterogeneous type of an atherosclerotic plaque (P<0.05) and ulceration of its surface (P<0.05). The presence of the patient’s baseline functional class III angina of effort appeared to be a risk factor for the development of cardiovascular complications for carotid endarterectomy (P<0.05). No cardiovascular risk factors for carotid stenting were revealed. Based on the assessment of the risk factors thus detected, the authors worked out an algorithm of choosing an optimal treatment policy for patients presenting with carotid artery stenosis.

KEY WORDS: carotid endarterectomy, carotid stenting, carotid artery stenosis.

P. 113

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