Abstract:
Background In recent years, attention has been paid to the relationship between effect of carotid endarterectomy (CEA) or carotid artery stenting (CAS) in the treatment of carotid artery stenosis and cognitive function, which may provide new ideas for treatment of carotid stenosis.
Objective To compare the clinical and cognitive outcomes of CEA versus CAS in the treatment of carotid artery stenosis.
Methods Patients with carotid artery stenosis undergoing CEA or CAS in the First Medical Center of Chinese PLA General Hospital from September 2018 to September 2020 were enrolled. Clinical indexes (total effective rate, adverse events incidence cerebral ischemia, cerebral infarction and restenosis) and Montreal Cognitive Assessment Scale (MoCA) scores were recorded and compared between the two groups.
Results Finally 103 cases were included in the analysis, 54 cases in the CEA group and 49 cases in the CAS group. The adverse events (including cerebral ischemia, cerebral infarction and restenosis) occurred in 8 cases (14.81%) in the CEA group and 5 cases (10.20%) in the CAS group, but the difference was not statistically significant (P=0.458). The total effective rate of the CAS group was significantly higher than that of the CEA group (83.67% 41/49 vs 66.67% 36/54, P=0.047). The MOCA score at baseline were similar between the two groups; at 3 months after operation, it was higher in CAS group (23.26 ± 2.55) compared to the CEA group (18.48 ± 2.41) (P＜0.001).
Conclusion CEA and CAS are effective in the treatment to carotid artery stenosis, with few adverse events and high safety, while CAS group have better cognitive function and higher total effective rate.
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