Comparison of nonneurological events in high-risk patients treated by carotid angioplasty versus endarterectomy |
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Authors: | Kasirajan Karthikeshwar Matteson Brian Marek John M Langsfeld Mark |
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Institution: | University of New Mexico School of Medicine, Division of Vascular Surgery, 2-ACC, 915 Camino de Salud, NE, Albuquerque, NM 87131-5341, USA. kkasirajan@salud.unm.edu |
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Abstract: | OBJECTIVE: To compare results of carotid angioplasty and stenting (CAS) with carotid endarterectomy (CEA) in high cardiac risk patients. METHODS: Patients ineligible for carotid revascularization by North American Symptomatic Carotid Endarterectomy Trial/Asymptomatic Carotid Atherosclerosis Study criteria were treated with CAS (n = 11) or CEA (n = 10). RESULTS: Significant numbers had cardiac (CAS 72%, CEA 60%; P = 0.66) and hypertensive (CAS 82%, CEA 80%; P = 0.64) risk factors. Adverse hemodynamic events were more frequent in the CAS group (CAS 73%, CEA 20%; P = 0.03). Major complications were noted in 1 patient in each group (CAS, myocardial infarction; CEA, death). Postoperative stay was similar (CAS 2.1 +/- 1.4, CEA 1.8 +/- 1.1 days; P = 0.60). However, 4 in the CAS group were readmitted within 1 month (congestive heart failure 2, myocardial infarction 1, rest pain 1), compared with no new events in the CEA group (P = 0.09). CONCLUSIONS: Currently, the use of CAS in patients with cardiac risk factors may not be justifiable. |
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Keywords: | Carotid angioplasty Carotid endarterectomy |
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