Abstract Details

Title Long-Term Outcome of Carotid Stenting, Endarterectomy and Best Medical Therapy at a Private Hospital in Mexico

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) (-)

Poster/Presentation
Number 008

Objective

Background Carotid artery stenosis causes up to 10% of all ischemic strokes. Randomized clinical trials have demonstrated that CEA is superior to BMT for stroke prevention. CAS has emerged as a less invasive alternative. In Mexico, there are no trials comparing long-term outcome of these procedures. We therefore compared long-term outcomes of BMT, CEA and CAS.

Design/Methods A retrospective, longitudinal, observational, cohort study that included all patients diagnosed with carotid artery stenosis (> 50%) between January 2007 and December 2011with duplex ultrasonography, magnetic resonance angiography, computed tomography angiography or catheter-based contrast angiography. Clinical and follow-up information was obtained through hospitalization records and telephone interviews. The purpose was to determine time-free of a major cardiovascular event (death, stroke or myocardial infarction).

Results After a median follow-up of 33.15 months, 123 patients were divided into 3 groups depending on treatment received; BMT (n=69), CEA (n=14) and CAS (n=40). The mean myocardial infarction-free survival time was 54 months (95% CI, 49-59) for BMT, 58 months (95% CI, 45-70) for CEA and 63 months (95% CI, 57-68) for CAS (p = 0.50). The mean stroke-free survival time was 49 months (95% CI, 43-54) for BMT, 59 months (95% CI, 46-70) for CEA and 58 months (95% CI, 50 - 65) for CAS (p = 0.355). The mean survival time was 55 months (95% CI; 50-59) for BMT, 51 months (95% CI, 37-65) for CEA and 62 months (95% CI, 55-68) for CAS (p = 0.239).

Conclusions We found no statistically significant difference in time free of a mayor cardiovascular event in the three groups. Larger studies are required to reevaluate our conclusions.

Authors/Disclosures
Giovana Femat, MD (Hospital San Jose Tec De Monterrey) PRESENTER	No disclosure on file
Luis Espinosa, MD	No disclosure on file
Juanzhi Fang (EMD Serono)	No disclosure on file
Hector R. Martinez, MD (Instituto de Neurología y Neurocirugía Hospital Zambrano Hellion)	Dr. Martinez has nothing to disclose.

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