Carotid endarteriectomy and carotic stenting. Pilot study of a prospective, randomized and controlled comparison

Introduction. A prospective, randomized and controlled trial is conducted t o compare carotid endarterectomy and carotid stenting in high grade symptom atic carotid artery stenoses. Methods. According to the study design symptomatic patients with a angiogra phically highgrade (greater than or equal to 70%) internal carotid artery s tenosis are included. Pre- and postinterventional diagnostics during the ho spitalization period includes neurological assessment, duplex sonography of the cervical and cerebral arteries and magnetic resonance imaging of the b rain. Follow-up examinations are scheduled after 1,6 and 12 months and cons ist of a neurological assessment and duplex sonography. After 12 months sel ective angiography and magnetic resonance imaging of the brain will be perf ormed additionally. During a period of 9 months up to now 23/137 patients t reated for a carotid artery stenosis were included in the study,ll patients underwent surgery and 12 patients carotid stenting. Results. Carotid stenting and endarterectomy was primarily successful witho ut residual stenosis >30% in each patient without the occurence of stroke o r death. In 18 follow-up examinations (neurological assessment including du plex sonography) of 13 patients (13 follow-up examinations after 30 days, 5 after 6 months) no relevant restenosis and no stroke occured. Conclusion. As of yet, carotid stenting was a safe procedure. Due to the sm all number of patients a definitive conclusion can not be drawn.