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Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
May 24-25, 2018
London, UK
Vascular Surgery 2018
Page 17
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
Objective:
Debate about carotid endarterectomy (CEA) and
carotid stenting (CAS) efficacies continues despite many
reports. The aimof this study was to evaluate the early outcomes
and restenosis rate of CEA versus CAS using propensity score
matching (PSM).
Methods:
Retrospective review of database was conducted for
the patients who underwent CEA or CAS between January 2002
and December 2015 at a single institute. We investigated the 30-
day incidenceof amajor adverse clinical event (MACE; definedas
stroke, transient ischemic attack, myocardial infarction or death)
and procedure related complication, restenosis rate during the
follow up period. PSM were used to create a balanced group of
CEA and CAS patient who were matched for following factors:
age, gender, hypertension, diabetes, dyslipidemia, smoking,
atrial fibrillation, previous percutaneous coronary intervention
or coronary artery bypass grafting, valvular heart disease,
contralateral carotid occlusion, degree of carotid stenosis, and
symptomatic status. Comparisons of outcomes in this matched
group of patients were performed using logistic regression
analysis and log rank test.
Results:
Among total 1184 patients (654 CEA and 530 CAS),
matched groups of 452 CEA and 452 CAS were created after
PSM. Within the propensity-matched group, the CAS group was
showedhigher 30-day incidenceofMACE (7.5%vs. 2.4%; OR [odd
ratio] 3.261; 95% CI [confidence interval], 1.634-6.509; p=0.001)
but lower incidence of procedure related complication (1.5%
vs. 5.3%; OR, 0.199; CI, 0.075-0.528; p=0.001). The CAS group
showed higher restenosis rate (1.5% vs. 1.0% at 12months, 5.4%
vs. 1.2%at 24months; p=0.008) than CEA group during themean
49.1 months follow up period (range, 1-180 months).
Conclusion:
In this study based on propensity score matching
analysis, CEA showed lower 30-day incidence of major adverse
clinical event and restenosis rate during the followup period than
CAS for revascularization of carotid artery stenosis.
Recent Publications
1. Kyu Hyun Han and Dong Ik Kim (2016) Enhancement of
angiogenic effects by hypoxia-preconditioned human
umbilical cord derived mesenchymal stem cells in a
mouse ischemic limb model. Cell Biology International
40(1):27-35.
2. AeKyeongKimandDong IkKim(2016) Inhibitoryeffects
of mesenchymal stem cells in intimal hyperplasia
after balloon angioplasty. Journal of Vascular Surgery
63(2):510-517.
3. Seon Hee Heo and Dong Ik Kim (2015) Early results of
clinical application of autologous whole bone marrow
stem cell transplantation for critical limb ischemia
in patients with Buerger’s disease. Scientific Report
21:19690.
4. Keun Myoung Park and Dong Ik Kim (2015) Factors
affecting anatomical changes after endovascular
abdominal aortic aneurysm repair. Thoracic and
Cardiovascular Surgery 63(2):139-45.
5. SeungWonShin,DongIkKimandSoongHoUm(2014)A
fluorescence color-encoded lipid-supported polymeric
particle. Colloids and Surface B: Biointerfaces 122:840-
845.
Comparison of results between carotid
endarterectomy versus carotid artery stenting
using propensity score matching analysis
Dong Ik Kim
Sungkyunkwan University, South Korea
Dong Ik Kim, J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-001