CAS導入後のCEA治療成績

抄録

Carotid endarterectomy (CEA) is a standard method to prevent stroke in patients with carotid artery stenosis. Carotid artery stenting (CAS) is a newly developed alternative method that we brought to our hospital in 2013. We selected CEA or CAS based on the procedure-related risks specific to each case. High-risk patients, such as those with vulnerable plaque, were more often treated with CEA, which may have influenced the outcomes. This study revealed the clinical results of CEA after introducing CAS.
Retrospectively collected data for 26 patients each of CEA and CAS performed in our hospital from April 2013 to March 2016 were analyzed. CEA was performed in 22 men and 4 women aged 36-82 years (mean, 66.9 ± 12.9 years). Stenosis rate was 40-99% (mean, 74.9 ± 19.9%). Twenty-two patients underwent CEA because of plaque morphologies, including vulnerable plaque, long plaque, mobile plaque, hematoma in and around the plaque, and heavily calcified plaque. Postoperative complications occurred as follows: transient hemiparalysis in 1 patient, transient hoarseness in 1 patient, pneumonia in 2 patients, and heart failure in 1 patient. No permanent morbidities were recognized. In 3 patients, spotty diffusion-weighted images of high-intensity signal lesions were obtained on post-operative magnetic resonance imaging.
Even after adopting CAS in our hospital, CEA was performed with low and acceptable complication rates.