Combined treatment using CEA and CAS for carotid arterial stenosis

Abstract

In this study we report our surgical results of CAS and CEA for carotid stenosis and suggest an appropriate treatment strategy for patients with high risks such as bilateral carotid stenosis or medical risk factors. From January 2001 to December 2005 we surgically treated 182 patients with carotid stenosis. Seventy-nine lesions were treated by CEA and 145 by CAS, respectively. Although CEA was considered the first choice for severe carotid stenosis, CAS was chosen for treatment when CEA was considered a higher risk for patients. Stenosis of carotid arteries was relieved in all cases after CEA or CAS. Surgical mortality of CEA was 1.1% (1=94). Surgical mortality of CAS was 0.7% (1=145). Carotid stenotic lesions can be treated with comparably low morbidity and mortality rates using CEA or=and CAS considering each characteristic of carotid stenosis of patients even with medically high risk or bilateral carotid stenosis.

Clinical Characteristics and Outcomes in Carotid Endarterectomy for Internal Carotid Artery Stenosis in a Japanese Population: 10-Year Microsurgical Experience

“…Another multicenter cohort study in Japan reported that 25 of 1596 patients (1.6%) had new neurologic symptoms due to ipsilateral ischemic stroke and 18 patients (1.1%) experienced lower cranial nerve palsy 30 days after CEA. 15 In a recent single-institution Japanese study, Tsukahara et al 16 In the present study, we measured CBF by SPECT immediately after CEA to identify postoperative hyperperfusion. We detected postoperative hyperperfusion in 8 patients (5.6%), most of whom had symptomatic ICA stenosis.…”

Gene expression analysis: Regulation of key genes associated with mycophenolate mofetil treatment of symptomatic carotid artery stenosis

“…The treatment of CAS includes three modalities: Medical management, carotid artery angioplasty and stenting, and CEA ( 26 ). However, there are doubts regarding the efficacy of carotid artery angioplasty and stenting, and CEA, in specific patients ( 27 – 29 ). Previous studies have aimed to identify novel treatments and medications for atherosclerosis.…”