Abstract

HAMDAN, Nabil et al. Angioplasty treatment and stent implant vs. surgical treatment in patients with stenosis of the cervical carotid artery. Rev. Colomb. Cardiol. [online]. 2006, vol.12, n.6, pp.431-437. ISSN 0120-5633.

Introduction and objectives: angioplasty with stent implant is a less invasive procedure than surgical intervention in the treatment of significant stenosis of the common cervical carotid artery (common and internal) (5). Currently the major published studies in which angioplasty and surgical treatment are compared, show similar results in the major events, as cerebrovascular accidents and mortality, but a greater significant difference in the apparition of acute myocardial infarction, during surgical intervention (5,11). The objective of this study is to compare in both treatment methods the major and minor clinical events, like cerebrovascular accident, acute myocardial infarction, death, bradycardia, hypotension and encephalopathy during the intervention, the hospitalization and the follow-up year, as well as the re-intervention, the time of hospital stay and the complications of the surgical incision. Materials and methods: in this study of historical cohort, 46 patients with significant stenosis of the cervical carotid arteries, who were subjected to intervention from January 1st 2001 to December 31st 2003, were included. 21 patients were treated with angioplasty and stent implant and 25 with surgery (endarterectomy) Results: 1 (4.8%) major cerebrovascular accident occurred during angioplasty, whereas none occurred in the patients treated with surgery. 1 (4%) acute myocardial infarction occurred during intervention in the group of patients treated with surgery, and none in the patients treated with angioplasty. No deaths occurred in any of the groups during intervention, hospitalization and the follow-up year. After 8 months 1 (4%) patient treated with surgery was intervened again with angioplasty and stent implant. There were no statistically significant differences between both groups during hospitalization, and in the apparition of minor complications as bradycardia and hypotension. 2 (8%) complications related to the incision of the neck compromising cranial nerves, occurred in the group of patients treated with surgery. Conclusion: this study showed that the probability of occurrence of a cerebrovascular accident and acute myocardial infarction is similar in the treatment of cervical carotid artery stenosis during procedure and hospitalization with both angioplasty with stent implant and surgery. Although a re-intervention and a cerebrovascular accident occurred in the group of patients treated with surgery during the follow-up year, no statistically significant differences with the group of patients treated with angioplasty were established.

Keywords : balloon angioplasty; stent; surgery; acute myocardial infarction; cerebrovascular accident.

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