Asymptomatic vs. Symptomatic Carotid Revascularization: A Single Institution Retrospective Review.

IF 1.6 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2026-10-16 DOI:10.1016/j.avsg.2026.09.063

Nuverah Mohsin, Zackery Aldaher, Ankit Dhiman, Michelle Patel, Andrew Soo Hoo, Omar El-Shazly, Gautam Agarwal, William Jordan

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引用次数: 0

Abstract

Background: While carotid revascularization reduces stroke risk in both asymptomatic (AD) and symptomatic (SD) carotid disease, its role continues to evolve with advances in medical therapy, surgical techniques, and cost considerations.

Methods: This retrospective study reviews outcomes of patients undergoing revascularization at a level one stroke center between 2019 and 2024. Primary endpoints were ipsilateral stroke, myocardial infarction, and death at 30-day, 90-day, and 1-year. Secondary endpoints include restenosis rates.

Results: 113 patients underwent 127 carotid endarterectomies. Sixty-four percent presented with SD, with a median time to intervention of 9 days (IQR 6-11). SD patients had a longer median length of stay (2 vs 1 day, p = 0.076. Follow-up rates were higher in AD at 1 year (65% vs 36%, p = 0.003). MI rates were 0% at 30- and 90-day and 0.9% at 1-year. Stroke rates were 0.9%, 0.9%, and 1.8% at 30-day, 90-day, and one year, with no difference between AD vs SD. 1-year mortality rates were 0.9% and 5.3% at 90-day and one year, without a difference by AD vs SD. Restenosis occurred in 4% of patients, with no difference between groups.

Conclusions: Carotid endarterectomy was associated with low perioperative rates of ipsilateral stroke, MI, and death. Despite a longer LOS, SD patients did not have significantly different outcomes or restenosis rates. While males had improved follow-up rates, there was no significant difference in outcomes by gender or race. These findings support favorable outcomes following CEA in both AD and SD.

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无症状与有症状的颈动脉重建术：单一机构的回顾性研究。

背景：虽然颈动脉血运重建术可以降低无症状（AD）和有症状（SD）颈动脉疾病的卒中风险，但其作用随着药物治疗、手术技术和成本考虑的进步而不断发展。方法：本回顾性研究回顾了2019年至2024年在一级脑卒中中心接受血运重建术的患者的结果。主要终点为30天、90天和1年的同侧卒中、心肌梗死和死亡。次要终点包括再狭窄率。结果：113例患者行颈动脉内膜切除术127例。64%的患者出现SD，干预的中位时间为9天（IQR 6-11）。SD患者的中位住院时间更长（2天vs 1天，p = 0.076）。AD患者1年随访率较高（65% vs 36%, p = 0.003）。30天和90天的心肌梗死率为0%，1年的心肌梗死率为0.9%。卒中发生率在30天、90天和一年时分别为0.9%、0.9%和1.8%，AD和SD之间没有差异。在90天和1年时，1年死亡率分别为0.9%和5.3%，无AD与SD差异。4%的患者发生再狭窄，组间无差异。结论：颈动脉内膜切除术与同侧卒中、心肌梗死和死亡的围手术期发生率低相关。尽管LOS较长，但SD患者的预后或再狭窄率没有显著差异。虽然男性的随访率有所提高，但性别或种族在结果上没有显著差异。这些发现支持CEA治疗AD和SD的有利结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence