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D. ANGILETTA (Bari)

D. ANGILETTA (Bari). Università degli Studi di Bari U.O.C. DI CHIRURGIA VASCOLARE ED ENDOVASCOLARE CATTEDRA E SCUOLA DI SPECIALIZZAZIONE IN CHIRURGIA VASCOLARE ed ENDOVASCOLARE Direttore : PROF. GUIDO REGINA. STENTING ED ENDOARTERIECTOMIA NELLO STESSO PAZIENTE: RISULTATI A BREVE E LUNGO TERMINE

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D. ANGILETTA (Bari)

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  1. D. ANGILETTA (Bari)

  2. Università degli Studi di BariU.O.C. DI CHIRURGIA VASCOLARE ED ENDOVASCOLARECATTEDRA E SCUOLA DI SPECIALIZZAZIONE IN CHIRURGIA VASCOLARE ed ENDOVASCOLAREDirettore : PROF. GUIDO REGINA STENTING ED ENDOARTERIECTOMIA NELLO STESSO PAZIENTE: RISULTATI A BREVE E LUNGO TERMINE D. Angiletta, D. Marinazzo, M. Ciccone*, F. Perilli, M. Plantamura, M. Fullone, G. Regina * Dept of Cardiology

  3. Aim of the study Comparing CAS and CEA effectiveness in the same patient, in order to avoid any confounding influence due to patient’s inherent risk factors. Aug. 2012

  4. Methods 45 patients / 90 procedures 34 Males, mean age 70 +7 years Eversion CEA and CAS (EZ wire Boston Scientific + Precise stent ) The same carotid-colour Doppler ultrasonograph (Hewlett Packard Sonos 1000, Andover, MA, USA) was used in all the exams. Furthermore, in order to reduce bias, a single expert ultrasonographer managed all the echo-colour Doppler evaluations All patients underwent a first intervention, CAS or CEA followed by the alternative compared procedure, on the controlateral side

  5. Methods Patients were re-evaluated as part of the routinely post-operative management, at 30-60 days and at one year follow-up after both procedure, with an echo-colour Doppler examination of carotid arteries in order to assess the effectiveness of the revascularization treatment Patients belong simultaneously to the control group and the study group

  6. Patient’s Demographics

  7. Endpoints Primary : TIA, stroke, myocardial infarction and death Secondary : Percentage of restenosis evaluated by ultrasound at 30, 180, >365 days follow-up times.

  8. Revascularization Timing

  9. Results • Averagestenosisvaluepreinterventionwas 72+11% and resultednot significative among CEA and CAS groupaswellasplaquemorphology • Peri and postperative TIA, stroke, myocardial infarction and death were not statistically significant

  10. Long Term Results CEA CAS * from revascularization procedure (CEA and CAS) Percentage of restenosis at 30,180, >360 days were 0+1, 5+6, 17+10 in CAS group and 2+5,12+18, 25+22 in CEA group respectively (p<0.01)

  11. Conclusions Carotid stenting results to be as effective as carotid endarterectomy CAS seems to confer some additional advantages in the long term follow up

  12. CEA or CAS? • Neurological symptoms • Plaque morphology • Vessel anatomy • Patient risk factors • Scientific Trials

  13. Thank you for your attention

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