Comparision of perioperative cerebrovascular events through different surgical approaches for severe bilateral carotid artery stenosis

Objective To explore the feasibility and safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with severe bilateral carotid stenosis. Methods From Jul 2003 to Sep 2017, unilateral CEA or CAS were performed in 1 046 patients , 213 of which were with severe bilateral carotid stenosis.These 213 patients were divided into CEA group and CAS group according to procedures taken. The perioperative outcomes of 213 patients were analyzed retrospectively. Results The incidence of typical cerebral ischemia symptoms of CEA group was higher than that in CAS group (25.3% vs.13.3%, P=0.029). The incidence of perioperative death or stroke in CEA group was 5.63%(4/71), which had no significant difference with that in CAS group(2.82%, 4/142)(P=0.524). Conclusion Based on adequate preoperative assessment and reasonable surgical selection, CEA and CAS are both safe and feasible for the unilateral lesion during one-stage operation for patients with severe bilateral carotid stenosis Key words: Carotid stenosis; Endarterectomy, carotid; Stents; Stroke