Limits...
Clinical outcomes of staged bilateral carotid endarterectomy for bilateral carotid artery stenosis.

Kim A, Kwon TW, Han Y, Kwon SU, Kwon H, Noh M, Cho YP - Ann Surg Treat Res (2015)

Bottom Line: Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes.Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up.The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: This retrospective cohort study aimed to determine the clinical outcomes of staged bilateral carotid endarterectomy (CEA) for bilateral internal carotid artery (ICA) stenosis performed with a short interval between the primary and secondary CEA procedures.

Methods: In our institution, 574 consecutive patients underwent CEA between September 2007 and August 2014. Bilateral significant ICA stenosis was identified in 43 patients (7.5%) who underwent staged bilateral CEA within 30 days or less. Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke within 3 years after the CEA.

Results: Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates.

Conclusion: Patients with bilateral significant ICA stenosis can undergo staged bilateral CEA within 30 days or less with outcomes that compare favorably with those of patients undergoing unilateral CEA.

No MeSH data available.


Related in: MedlinePlus

Ipsilateral stroke-free (A), any stroke-free (B), and overall survival rates (C) for patients who underwent unilateral carotid endarterectomy (CEA) and staged bilateral CEA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4644907&req=5

Figure 2: Ipsilateral stroke-free (A), any stroke-free (B), and overall survival rates (C) for patients who underwent unilateral carotid endarterectomy (CEA) and staged bilateral CEA.

Mentions: Patient age was the only risk factor significantly associated with ipsilateral stroke in univariate (P = 0.045) and multivariate (P = 0.024) analyses (Table 2). Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The groups who underwent unilateral CEA and staged bilateral CEA did not differ significantly in terms of primary endpoints during the periprocedural period (1.5% vs. 2.3%, P = 0.677) or in the estimated 3-year primary endpoints (2.8% vs. 4.7%, P = 0.456) (Table 3). There were no statistically significant differences between the unilateral CEA and staged bilateral CEA groups with regard to any solitary component of the primary endpoint. Kaplan-Meier survival analysis showed that the two groups had similar rates of ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), and overall (P = 0.739) survival (Fig. 2).


Clinical outcomes of staged bilateral carotid endarterectomy for bilateral carotid artery stenosis.

Kim A, Kwon TW, Han Y, Kwon SU, Kwon H, Noh M, Cho YP - Ann Surg Treat Res (2015)

Ipsilateral stroke-free (A), any stroke-free (B), and overall survival rates (C) for patients who underwent unilateral carotid endarterectomy (CEA) and staged bilateral CEA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644907&req=5

Figure 2: Ipsilateral stroke-free (A), any stroke-free (B), and overall survival rates (C) for patients who underwent unilateral carotid endarterectomy (CEA) and staged bilateral CEA.
Mentions: Patient age was the only risk factor significantly associated with ipsilateral stroke in univariate (P = 0.045) and multivariate (P = 0.024) analyses (Table 2). Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The groups who underwent unilateral CEA and staged bilateral CEA did not differ significantly in terms of primary endpoints during the periprocedural period (1.5% vs. 2.3%, P = 0.677) or in the estimated 3-year primary endpoints (2.8% vs. 4.7%, P = 0.456) (Table 3). There were no statistically significant differences between the unilateral CEA and staged bilateral CEA groups with regard to any solitary component of the primary endpoint. Kaplan-Meier survival analysis showed that the two groups had similar rates of ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), and overall (P = 0.739) survival (Fig. 2).

Bottom Line: Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes.Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up.The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: This retrospective cohort study aimed to determine the clinical outcomes of staged bilateral carotid endarterectomy (CEA) for bilateral internal carotid artery (ICA) stenosis performed with a short interval between the primary and secondary CEA procedures.

Methods: In our institution, 574 consecutive patients underwent CEA between September 2007 and August 2014. Bilateral significant ICA stenosis was identified in 43 patients (7.5%) who underwent staged bilateral CEA within 30 days or less. Patients with unilateral CEA and staged bilateral CEA were compared in terms of CEA outcomes. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the periprocedural period or ipsilateral stroke within 3 years after the CEA.

Results: Staged bilateral CEA was not associated with ipsilateral stroke (P = 0.178) during postoperative follow-up. The two groups did not differ in terms of estimated 3-year primary endpoint rates (2.8% vs. 4.7%, P = 0.456) or ipsilateral stroke-free (P = 0.225), any stroke-free (P = 0.326), or overall (P = 0.739) survival rates.

Conclusion: Patients with bilateral significant ICA stenosis can undergo staged bilateral CEA within 30 days or less with outcomes that compare favorably with those of patients undergoing unilateral CEA.

No MeSH data available.


Related in: MedlinePlus