Key result
CEA in carotid near-occlusion with full collapse linked to ~58% lower 30-day major events.
Why the study?
The preliminary experience and outcomes of carotid endarterectomy for carotid near-occlusion with recurrent symptoms, including the impact of distal full collapse, were not well reported.
Does the presence of distal full collapse affect the outcomes of carotid endarterectomy in patients with carotid near-occlusion and recurrent symptoms?
Cohort (n=122)
No
Does the presence of distal full collapse affect the outcomes of carotid endarterectomy in patients with carotid near-occlusion and recurrent symptoms?
Absolute Event Rate: 1.85% vs 4.41%
Carotid endarterectomy appears to have comparable short- and mid-term outcomes in patients with carotid near-occlusion and recurrent symptoms, regardless of the presence of distal full collapse.
CEA appears safe in symptomatic near-occlusion regardless of collapse; extends observational data but leaves randomized confirmation open.
Objective: Report our preliminary experience of carotid endarterectomy (CEA) for the treatment of carotid near-occlusion (CNO) with recurrent symptoms. Materials and Methods: Retrospectively analyze the demographics, treatment detail, and outcomes data of 122 patients with CNO from 2014 to 2020. According to whether distal full collapse exists, patients were classified into the full collapse group and the non-full collapse group. The incidence of death, myocardial infarction, stroke, and other variables were compared between the two groups. Results: A total of 122 patients with CNO and recurrent symptoms were enrolled. The demographics were comparable between the two groups. Thirty-day incidence of primary endpoints was 1.85% in the full collapse group and 4.41% in the non-full collapse group. Twelve-month incidence of primary endpoints was 7.41% in the full collapse group and 4.41% in the non-full collapse group. One re-stenosis occurred in the non-full collapse group 8 months after CEA. Conclusion: For patients with CNO with recurrent symptoms, CEA is not worse than the results described in historical control groups, despite whether distal full collapse exists. The shunt is important to avoid intraoperative hypoperfusion and postoperative hyperperfusion. The long-term results should be further evaluated.
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Zhang et al. (2022) conducted a cohort in Carotid near-occlusion (CNO) with recurrent symptoms (n=122). Carotid endarterectomy (CEA) in CNO with full collapse vs. Carotid endarterectomy (CEA) in CNO without full collapse was evaluated on 30-day incidence of death, ipsilateral stroke, and myocardial infarction. Carotid endarterectomy for symptomatic carotid near-occlusion demonstrated a 30-day primary composite endpoint rate of 1.85% in patients with full collapse and 4.41% in those without full collapse.
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