Clinical outcome analysis of carotid endarterectomy and carotid artery stenting for internal carotid artery stenosis

Objective To investigate the safety and efficacy of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for the treatment of internal carotid artery stenosis. Methods This study retrospectively analyzed 136 patients who underwent surgical treatment of internal carotid artery stenosis at the First Affiliated Hospital of Soochow University from July 2017 to December 2018. Among those, 78 underwent CEA (CEA group) at Department of Neurosurgery and the other 58 underwent CAS (CAS group) at Department of Interventional Radiology. General data, time of surgery, postoperative complications, postoperative hospital stay, hospitalization cost, and incidence of postoperative restenosis were compared between the 2 groups. Results There was no difference in the age, gender, lesion side, preoperative comorbidity, preoperative complication or preoperative internal carotid artery stenosis rate between 2 groups (all P>0.05). There was no significant difference in operation time, postoperative complications or the incidence of postoperative restenosis between 2 groups (all P>0.05). The follow-up period was 3 to 21 months. The postoperative hospital stay in CEA group was shorter than that in CAS group (6.5±2.3 d vs. 8.3±1.4 d, P<0.01), and the hospitalization cost in CEA group was lower than that in CAS group (57±10 thousand yuans vs. 103±18 thousand yuans, P<0.01). Conclusions For patients with internal carotid artery stenosis, both CEA and CAS seem safe and effective. In terms of hospital length-of-stay and economic factors, CEA has certain advantages over CAS. Key words: Carotid stenosis; Endarterectomy, carotid; Carotid artery stenting; Treatment outcome