Differential Effects of Carotid Artery Stenting versus Carotid Endarterectomy on External Carotid Artery Patency

Purpose:To determine the effect of stent coverage of the external carotid artery (ECA) after carotid artery stenting (CAS) compared to eversion endarterectomy of the ECA after carotid endarterectomy (CEA).Methods:The records of 101 CAS and 165 CEA procedures performed over 2 years were reviewed. Duplex velocities and history and physical examinations were taken prior to the procedure, at 1 month, and at 6-month intervals subsequently. CAS was performed by extending the stent across the internal carotid artery (ICA) lesion into the common carotid artery (CCA) thereby covering the ECA. CEA was performed with eversion endarterectomy of the ECA.Results:The mean peak systolic velocities (PSV) in the ICA pre-CAS and pre-CEA were 361 and 352 cm/s, respectively. In terms of CAS, there was a significant increase in ECA velocities versus baseline at 12 (p=0.009), 18 (p=0.00001), and 24 (p=0.005) months. In the CEA group, there was a significant decrease in ECA velocities versus baseline at 1 (p=0.01) and 6 (p=0.004...