Long-Term Outcome After Carotid Artery Stenting

Abstract

2083 C arotid artery stenting (CAS) is a less invasive technique than carotid endarterectomy (CEA) for prevention of stroke in patients with carotid artery stenosis. Although reports from high-volume centers have demonstrated accept-able short-term results after CAS, randomized controlled trials (RCT) have demonstrated inferior results, in terms of stroke and death in the perioperative phase, after CAS com-pared with CEA. Little is known about the long-term results after CAS out-side the RCTs, and consequently the generalizability of these observations has been questioned, 9 and a recent Cochrane review pointed out the need for long-term outcome data after CAS. 10 Population-based, nonselected cohorts can provide additional evidence. 11 Our aim was to assess population-based, nationwide, long-term outcomes after CAS when compared with CEA during the same time period. Methods Study Design We established a nationwide cohort of all patients registered in the National Swedish Vascular Registry (Swedvasc) treated with CAS between 2005 and 2012 and matched controls treated with CEA during the same time period. Postoperative stroke was identified by cross-matching the cohort with the national InPatient Registry (IPR) supplemented with charts review. The study was approved by the regional ethics committee in Stockholm (EPN dnr 2012/1314–31), and written informed consent was not required.