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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Comparative Analysis of Carotid Artery Stenting and Carotid Endarterectomy in Clinical Practice
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Comparative Analysis of Carotid Artery Stenting and Carotid Endarterectomy in Clinical Practice

机译：颈动脉支架和颈动脉胚胎切除术在临床实践中的比较分析

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The objective of the study was to describe immediate and long-term results of carotid endarterectomy (CEA) versus carotid stenting (CAS) with embolic protection in patients with severe carotid artery stenosis in clinical practice. Materials and Methods: This is a retrospective cohort study, conducted between 2009 and 2017. During the analyzed period, 2132 operations (2006 patients) were performed: 1215 (57%) CEA and 917 (43%) CAS. 278 patients (13.8% of 2006) were not contactable during the follow-up period (>30 days) leaving 1791 cases (1728 patients) for inclusion in the analysis. Propensity score matching was used to compare the treatment results of groups (561 cases were matched out of 1791). The results of 615 CEA (316 eversion, 299 "classic" with patch) and 615 CAS (using a variety of carotid stents) were compared. Results: In the asymptomatic subgroup (n = 455), the 30-day rate of stroke was not significantly different between the CEA group and the CAS group (1.5% versus 2.4%, P = .48). The 5-year rate of stroke was not significantly higher for CAS than for CEA (4.6% versus 3.3%, P = .3). In the symptomatic subgroup (n = 160), the 30-day rate of stroke was significantly higher in the CAS group than in the CEA group (7.5% versus 2.5%, P = .04). The 5-year rate of stroke was 13% for CAS and 8.7% for CEA (P = .2). Conclusions: In the symptomatic subgroup, the 30-day rate of stroke was significantly higher in the CAS group than in the CEA group, therefore the use of CAS for symptomatic patients in routine practice should be limited. Our study demonstrates that the rates of stroke and survival after CEA and CAS in patients aged 80 years or younger with asymptomatic or symptomatic severe carotid stenosis did not differ significantly over a period of 5 years.
机译：本研究的目的是描述临床实践中严重颈动脉狭窄患者颈动脉内膜切除术（CEA）与带栓塞保护的颈动脉支架术（CAS）的近期和长期结果。材料和方法：这是一项回顾性队列研究，于2009年至2017年进行。在分析期间，共进行了2132次手术（2006例患者）：1215例（57%）CEA和917例（43%）CAS。278名患者（2006年的13.8%）在随访期间（>30天）无法联系到，剩下1791名患者（1728名患者）纳入分析。倾向评分匹配用于比较两组的治疗结果（1791例中匹配561例）。比较615例CEA（316例外翻，299例“经典型”带补片）和615例CAS（使用各种颈动脉支架）的结果。结果：在无症状亚组（n=455）中，CEA组和CAS组的30天卒中发生率无显著差异（1.5%对2.4%，P=0.48）。CAS患者的5年卒中发生率并不显著高于CEA患者（4.6%对3.3%，P=0.3）。在症状亚组（n=160）中，CAS组的30天中风发生率显著高于CEA组（7.5%对2.5%，P=0.04）。CAS和CEA的5年卒中率分别为13%和8.7%（P=0.2）。结论：在有症状的亚组中，CAS组的30天卒中发生率明显高于CEA组，因此在常规治疗中，对有症状的患者使用CAS应受到限制。我们的研究表明，在无症状或症状性严重颈动脉狭窄的80岁及以下患者中，CEA和CAS治疗后的卒中率和生存率在5年内没有显著差异。

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