Exploration of Neuroscience

Table 1. Baseline patient features for CEA and CAS

Variables	Total (n = 270)	CAS (n = 148)	CEA (n = 122)	P value
Age, mean ± SD	70.89 ± 12.14	73.42 ± 11.75	68.36 ± 12.53	< 0.05
Male gender	208 (77%)	110 (74%)	98 (80%)	0.092
Qualifying events
Amaurosis fugax	38 (14%)	23 (16%)	15 (12%)	0.586
TIA	138 (51%)	64 (43%)	74 (61%)	0.058
Stroke	22 (8%)	10 (7%)	12 (10%)	0.078
Asymptomatic	72 (27%)	28(19%)	44 (36%)	< 0.05
Diabetes mellitus	124 (46%)	66 (46%)	58 (48%)	0.896
Hypertension	186 (69%)	112 (76%)	74 (61%)	0.095
Smoker	179 (66%)	93 (63%)	86 (71%)	0.084
CAD	168 (62%)	102 (69%)	66 (54%)	0.243
Previous MI	94 (35%)	62 (42%)	32 (26%)	0.128
Previous CABG	38 (14%)	22 (15%)	16 (13%)	0.765
Previous PTCA	129 (48%)	72 (49%)	57 (47%)	0.923
Atrial fibrillation	46 (17%)	27 (18%)	19 (16%)	0.856
PAD	38 (14%)	26 (18%)	12 (10%)	0.085
COPD	40 (15%)	32(22%)	8 (7%)	< 0.05
HDL, mean ± SD (mg/dL)	36.68 ± 7.84	36.28 ± 7.35	37.08 ± 8.33	0.062
LDL, mean ± SD (mg/dL)	129.02 ± 29.35	119.56 ± 28.84	138.48 ± 29.86	< 0.05
Triglycerides, mean ± SD	208.32 ± 103.59	204.36 ± 84.42	212.28 ± 122.76	0.278
Creatinine, mean ± SD (mg/dL)	1.14 ± 0.39	1.12 ± 0.46	1.16 ± 0.32	0.153
Glucose, mean ± SD (mg/dL)	145.38 ± 64.31	142.53 ± 62.24	148.23 ± 66.38	0.385
Preprocedural medication
Aspirin	227 (84%)	115 (78%)	112 (92%)	0.238
Clopidogrel	178 (66%)	108 (73%)	70 (57%)	0.285
Antihypertensive	186 (69%)	112 (76%)	74 (61%)	0.095
Statin	270 (100%)	148 (100%)	122 (100%)	0.994

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Significant values are in bold. SD: standard deviation; CAD: coronary artery disease; PTCA: percutaneous transluminal coronary angioplasty; PAD: peripheral artery disease; HDL: high-density lipoprotein

Declarations

Acknowledgments

We thank Dr. Izatullah Jalalzai on language editing and improving the article.

Author contributions

OB: Conceptualization, Formal analysis, Data curation, Investigation, Resources, Project administration, Writing—original draft. ESÇ: Conceptualization, Formal analysis, Data curation, Investigation, Methodology, Writing—original draft, Supervision, Project administration. ÜA: Conceptualization, Data curation, Investigation, Resources, Supervision, Writing—original draft. YK: Conceptualization, Data curation, Investigation, Resources, Supervision, Writing—review & editing. UK: Conceptualization, Formal analysis, Data curation, Investigation, Methodology, Resources, Writing—review & editing. AÇ: Conceptualization, Investigation, Methodology, Resources, Supervision, Software, Validation. MHT: Conceptualization, Investigation, Supervision, Visualization, Project administration. All authors read and approved the final version of the manuscript.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was carried out according to the Declaration of Helsinki (as amended in 2013) and the approval of the Ethics Committee of the Atatürk University Faculty of Medicine was obtained for this study (B.30.2.ATA.0.01.00/714).

Consent to participate

For surgical or interventional procedures, patients’ informed consend was acquired, however, since the study was retrospective and the data were anonymized, informed consent was waived.

Consent to publication

Not applicable.

Availability of data and materials

On reasonable request, the corresponding author will provide the data supporting the study’s conclusions.

Funding

Not applicable.

Copyright

References

GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021;20:795–820. [DOI] [PubMed] [PMC]

Mas JL, Trinquart L, Leys D, Albucher JF, Rousseau H, Viguier A, et al.; EVA-3S investigators. Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicentre trial. Lancet Neurol. 2008;7:885–92. [DOI] [PubMed]

Taş MH, Simşek Z, Colak A, Koza Y, Demir P, Demir R, et al. Comparison of carotid artery stenting and carotid endarterectomy in patients with symptomatic carotid artery stenosis: a single center study. Adv Ther. 2013;30:845–53. [DOI] [PubMed]

North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–53. [DOI] [PubMed]

MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery Trialists’ Collaborative Group. Lancet. 1991;337:1235–43. [PubMed]

Brown K, Itum DS, Preiss J, Duwayri Y, Veeraswamy RK, Salam A, et al. Carotid artery stenting has increased risk of external carotid artery occlusion compared with carotid endarterectomy. J Vasc Surg. 2015;61:119–25. [DOI] [PubMed] [PMC]

Brooks WH, McClure RR, Jones MR, Coleman TL, Breathitt L. Carotid angioplasty and stenting versus carotid endarterectomy for treatment of asymptomatic carotid stenosis: a randomized trial in a community hospital. Neurosurgery. 2004;54:318–25. [DOI] [PubMed]

Brott TG, Howard G, Roubin GS, Meschia JF, Mackey A, Brooks W, et al.; CREST Investigators. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016;374:1021–31. [DOI] [PubMed] [PMC]

Brooks WH, Jones MR, Gisler P, McClure RR, Coleman TC, Breathitt L, et al. Carotid angioplasty with stenting versus endarterectomy: 10-year randomized trial in a community hospital. JACC Cardiovasc Interv. 2014;7:163–8. [DOI] [PubMed]

10.

Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary^†. Catheter Cardiovasc Interv. 2013;81:E76–123. [DOI] [PubMed]

11.

Nielsen HB. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery. Front Physiol. 2014;5:93. [DOI] [PubMed] [PMC]

12.

Zhang L, Zhao Z, Ouyang Y, Bao J, Lu Q, Feng R, et al. Systematic review and meta-analysis of carotid artery stenting versus endarterectomy for carotid stenosis: a chronological and worldwide study. Medicine (Baltimore). 2015;94:e1060. Erratum in: Medicine (Baltimore). 2018;97:e9591. [DOI] [PubMed] [PMC]

13.

Taussky P, Hanel RA, Meyer FB. Clinical considerations in the management of asymptomatic carotid artery stenosis. Neurosurg Focus. 2011;31:E7. [DOI] [PubMed]

14.

Roffi M, Mukherjee D, Clair DG. Carotid artery stenting vs. endarterectomy. Eur Heart J. 2009;30:2693–704. [DOI] [PubMed]

15.

Meier P, Knapp G, Tamhane U, Chaturvedi S, Gurm HS. Short term and intermediate term comparison of endarterectomy versus stenting for carotid artery stenosis: systematic review and meta-analysis of randomised controlled clinical trials. BMJ. 2010;340:c467. Erratum in: BMJ. 2010;340:c1798. [DOI] [PubMed] [PMC]

16.

Liu ZJ, Fu WG, Guo ZY, Shen LG, Shi ZY, Li JH. Updated systematic review and meta-analysis of randomized clinical trials comparing carotid artery stenting and carotid endarterectomy in the treatment of carotid stenosis. Ann Vasc Surg. 2012;26:576–90. [DOI] [PubMed]

17.

Murad MH, Flynn DN, Elamin MB, Guyatt GH, Hobson RW 2nd, Erwin PJ, et al. Endarterectomy vs stenting for carotid artery stenosis: a systematic review and meta-analysis. J Vasc Surg. 2008;48:487–93. [DOI] [PubMed]

18.

Carotid Stenting Trialists’ Collaboration. Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis: a preplanned meta-analysis of individual patient data. Lancet. 2010;376:1062–73. [DOI] [PubMed]

19.

Bonati LH, Dobson J, Featherstone RL, Ederle J, van der Worp HB, de Borst GJ, et al.; International Carotid Stenting Study investigators. Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial. Lancet. 2015;385:529–38. [DOI] [PubMed] [PMC]

20.

Gray WA, Hopkins LN, Yadav S, Davis T, Wholey M, Atkinson R, et al.; ARCHeR Trial Collaborators. Protected carotid stenting in high-surgical-risk patients: the ARCHeR results. J Vasc Surg. 2006;44:258–68. Erratum in: J Vasc Surg. 2007;45:226. [DOI] [PubMed]

21.

CAVATAS investigators. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001;357:1729–37. [DOI] [PubMed]

22.

Barnett HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, et al.; North American Symptomatic Carotid Endarterectomy Trial Collaborators. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. N Engl J Med. 1998;339:1415–25. [DOI] [PubMed]

23.

Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, et al.; CREST Investigators. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11–23. Erratum in: N Engl J Med. 2010;363:498. Erratum in: N Engl J Med. 2010;363:198. [DOI] [PubMed] [PMC]

24.

Howard G, Roubin GS, Jansen O, Hendrikse J, Halliday A, Fraedrich G, et al.; Carotid Stenting Trialists’ Collaboration. Association between age and risk of stroke or death from carotid endarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials. Lancet. 2016;387:1305–11. Erratum in: Lancet. 2016;387:1276. [DOI] [PubMed]

25.

Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021;52:e364–467. Erratum in: Stroke. 2021;52:e483–4. [DOI] [PubMed]

26.

Müller MD, Lyrer PA, Brown MM, Bonati LH. Carotid artery stenting versus endarterectomy for treatment of carotid artery stenosis. Stroke. 2021;52:e3–5. [DOI] [PubMed]

27.

The SPACE Collaborative Group. 30 Day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet. 2006;368:1239–47. [DOI]

28.

Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, et al.; EVA-3S Investigators. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–71. [DOI] [PubMed]

29.

Kurian AL, Lucke-Wold B. Update on management of symptomatic carotid stenosis. J Neurosci Neurol Surg. 2023;13:255. [PubMed] [PMC]

30.

Luk Y, Chan YC, Cheng SW. Transcarotid artery revascularization as a new modality of treatment for carotid stenosis. Ann Vasc Surg. 2020;64:397–404. [DOI] [PubMed]

31.

Zhang JB, Fan XQ, Chen J, Liu P, Ye ZD. Acute carotid stent thrombosis: a case report and literature review. World J Clin Cases. 2022;10:9310–7. [DOI] [PubMed] [PMC]

32.

Willman M, Lucke-Wold B. Commentary on a case report and literature review of acute carotid stent thrombosis. World J Clin Cases. 2023;11:1666–8. [DOI] [PubMed] [PMC]