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Treatment Strategy for Bilateral Severe Carotid Artery Stenosis: One Center's Experience

ObjectiveTo describe 1 center's experience using carotid artery stenting (CAS) or carotid endarterectomy (CEA) as a treatment strategy in patients with bilateral carotid artery stenosis. MethodsPatients with severe carotid artery stenosis, including bilateral carotid artery stenosis, treated by CEA... Full description

Journal Title: World Neurosurgery September 2015, Vol.84(3), pp.820-825
Main Author: Liu, Bing
Other Authors: Wei, Wei , Wang, Yongli , Yang, Xinyu , Yue, Shuyuan , Zhang, Jianning
Format: Electronic Article Electronic Article
Language: English
Subjects:
Cas
Cea
Mrs
ID: ISSN: 1878-8750 ; DOI: 10.1016/j.wneu.2015.03.067
Link: http://dx.doi.org/10.1016/j.wneu.2015.03.067
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recordid: sciversesciencedirect_elsevierS1878-8750(15)00369-1
title: Treatment Strategy for Bilateral Severe Carotid Artery Stenosis: One Center's Experience
format: Article
creator:
  • Liu, Bing
  • Wei, Wei
  • Wang, Yongli
  • Yang, Xinyu
  • Yue, Shuyuan
  • Zhang, Jianning
subjects:
  • Carotid Artery Stenosis
  • Carotid Artery Stenting
  • Carotid Endarterectomy
  • Stroke
  • Cas
  • Cea
  • Crest
  • Eva-3s
  • Mrs
  • Nascet
  • Sapphire
  • Space
ispartof: World Neurosurgery, September 2015, Vol.84(3), pp.820-825
description: ObjectiveTo describe 1 center's experience using carotid artery stenting (CAS) or carotid endarterectomy (CEA) as a treatment strategy in patients with bilateral carotid artery stenosis. MethodsPatients with severe carotid artery stenosis, including bilateral carotid artery stenosis, treated by CEA or CAS during the period 2008–2013 were reviewed retrospectively. The selection of treatment depended on the individual patient's medical comorbidities, neurologic condition, and clinical and anatomic arterial factors. The main adverse events included death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from the treated carotid artery or ipsilateral major stroke. ResultsThere were 27 patients with bilateral carotid artery stenosis treated, including 11 patients with bilateral CEA, 9 patients with CEA on one side and CAS on the other side, and 7 patients with bilateral CAS. Of patients with unilateral carotid artery stenosis, 69 were treated with CEA, and 75 were treated with CAS. The incidence of main adverse events for the bilateral patients was 7.4%, similar to the unilateral patients undergoing CEA and CAS (8.7% and 6.7%, respectively). Restenosis occurred in 4 treated carotid arteries in bilateral patients within 1 year (4 of 54 [7.4%]); this was not significantly different from unilateral patients undergoing CEA and CAS (4 of 69 [5.8%] and 6 of 75 [8.0%], respectively). Local complications were not more frequent in bilateral patients. ConclusionsGood outcomes can be achieved in patients with bilateral carotid artery stenosis when treatment selection is based on each individual patient's clinical characteristics and with a proper combination of staged CEA and CAS.
language: eng
source:
identifier: ISSN: 1878-8750 ; DOI: 10.1016/j.wneu.2015.03.067
fulltext: fulltext
issn:
  • 18788750
  • 1878-8750
url: Link


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titleTreatment Strategy for Bilateral Severe Carotid Artery Stenosis: One Center's Experience
creatorLiu, Bing ; Wei, Wei ; Wang, Yongli ; Yang, Xinyu ; Yue, Shuyuan ; Zhang, Jianning
ispartofWorld Neurosurgery, September 2015, Vol.84(3), pp.820-825
identifierISSN: 1878-8750 ; DOI: 10.1016/j.wneu.2015.03.067
subjectCarotid Artery Stenosis ; Carotid Artery Stenting ; Carotid Endarterectomy ; Stroke ; Cas ; Cea ; Crest ; Eva-3s ; Mrs ; Nascet ; Sapphire ; Space
descriptionObjectiveTo describe 1 center's experience using carotid artery stenting (CAS) or carotid endarterectomy (CEA) as a treatment strategy in patients with bilateral carotid artery stenosis. MethodsPatients with severe carotid artery stenosis, including bilateral carotid artery stenosis, treated by CEA or CAS during the period 2008–2013 were reviewed retrospectively. The selection of treatment depended on the individual patient's medical comorbidities, neurologic condition, and clinical and anatomic arterial factors. The main adverse events included death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from the treated carotid artery or ipsilateral major stroke. ResultsThere were 27 patients with bilateral carotid artery stenosis treated, including 11 patients with bilateral CEA, 9 patients with CEA on one side and CAS on the other side, and 7 patients with bilateral CAS. Of patients with unilateral carotid artery stenosis, 69 were treated with CEA, and 75 were treated with CAS. The incidence of main adverse events for the bilateral patients was 7.4%, similar to the unilateral patients undergoing CEA and CAS (8.7% and 6.7%, respectively). Restenosis occurred in 4 treated carotid arteries in bilateral patients within 1 year (4 of 54 [7.4%]); this was not significantly different from unilateral patients undergoing CEA and CAS (4 of 69 [5.8%] and 6 of 75 [8.0%], respectively). Local complications were not more frequent in bilateral patients. ConclusionsGood outcomes can be achieved in patients with bilateral carotid artery stenosis when treatment selection is based on each individual patient's clinical characteristics and with a proper combination of staged CEA and CAS.
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titleTreatment Strategy for Bilateral Severe Carotid Artery Stenosis: One Center's Experience
descriptionObjectiveTo describe 1 center's experience using carotid artery stenting (CAS) or carotid endarterectomy (CEA) as a treatment strategy in patients with bilateral carotid artery stenosis. MethodsPatients with severe carotid artery stenosis, including bilateral carotid artery stenosis, treated by CEA or CAS during the period 2008–2013 were reviewed retrospectively. The selection of treatment depended on the individual patient's medical comorbidities, neurologic condition, and clinical and anatomic arterial factors. The main adverse events included death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from the treated carotid artery or ipsilateral major stroke. ResultsThere were 27 patients with bilateral carotid artery stenosis treated, including 11 patients with bilateral CEA, 9 patients with CEA on one side and CAS on the other side, and 7 patients with bilateral CAS. Of patients with unilateral carotid artery stenosis, 69 were treated with CEA, and 75 were treated with CAS. The incidence of main adverse events for the bilateral patients was 7.4%, similar to the unilateral patients undergoing CEA and CAS (8.7% and 6.7%, respectively). Restenosis occurred in 4 treated carotid arteries in bilateral patients within 1 year (4 of 54 [7.4%]); this was not significantly different from unilateral patients undergoing CEA and CAS (4 of 69 [5.8%] and 6 of 75 [8.0%], respectively). Local complications were not more frequent in bilateral patients. ConclusionsGood outcomes can be achieved in patients with bilateral carotid artery stenosis when treatment selection is based on each individual patient's clinical characteristics and with a proper combination of staged CEA and CAS.
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abstractObjectiveTo describe 1 center's experience using carotid artery stenting (CAS) or carotid endarterectomy (CEA) as a treatment strategy in patients with bilateral carotid artery stenosis. MethodsPatients with severe carotid artery stenosis, including bilateral carotid artery stenosis, treated by CEA or CAS during the period 2008–2013 were reviewed retrospectively. The selection of treatment depended on the individual patient's medical comorbidities, neurologic condition, and clinical and anatomic arterial factors. The main adverse events included death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from the treated carotid artery or ipsilateral major stroke. ResultsThere were 27 patients with bilateral carotid artery stenosis treated, including 11 patients with bilateral CEA, 9 patients with CEA on one side and CAS on the other side, and 7 patients with bilateral CAS. Of patients with unilateral carotid artery stenosis, 69 were treated with CEA, and 75 were treated with CAS. The incidence of main adverse events for the bilateral patients was 7.4%, similar to the unilateral patients undergoing CEA and CAS (8.7% and 6.7%, respectively). Restenosis occurred in 4 treated carotid arteries in bilateral patients within 1 year (4 of 54 [7.4%]); this was not significantly different from unilateral patients undergoing CEA and CAS (4 of 69 [5.8%] and 6 of 75 [8.0%], respectively). Local complications were not more frequent in bilateral patients. ConclusionsGood outcomes can be achieved in patients with bilateral carotid artery stenosis when treatment selection is based on each individual patient's clinical characteristics and with a proper combination of staged CEA and CAS.
pubElsevier Inc.
doi10.1016/j.wneu.2015.03.067
eissn18788769
date2015-09