Early complications of the revascularization methods in patients with stroke due to carotid artery stenosis

EARLY COMPLICATIONSIntroduction and Aim. Stroke is a disease which isolates the patient from thesocial life and the third leading cause of death. Carotid artery occlusive disease (CAOD)is the pathophysiological background in 10-20% of all cases with stroke. Carotidangioplasty and stenting is a less invasive alternative for the CAOD in comparison withcarotid endarterectomy. The feasibility and the safety of this procedure has increased bythe development of cerebral protective systems.The purpose of this study was to analyze the early complications of therevascularization treatment methods which have been performed to prevent therecurrence of stroke in patients referring with a stroke and/or transient ischemic attackdue to carotid artery stenosis.Material and Method. Of the patients who have referred with ischemic attack, vertigo,amourasis fugax and stroke to the Neurology Department of Inonu University MedicalFaculty Turgut Ozal Medical Center between January 2006 and January 2013 and havebeen determined as having carotid artery stenosis, 40 patients to whom stenting tocarotid artery was performed by Radiology Department and 70 patients to whom carotidendarterectomy was performed by Neurosurgery Department were involved in ourstudy.Major risk factors for carotid artery stenosis such as hyperlipidemia, hypertension,diabetes mellitus, coronary artery disease, coronary artery by-pass grafting and smoking history were questioned prior to the procedure in patients whom carotid endarterectomyor carotid artery stenting has been performed.The early complications during and within the first month of the procedure wereevaluated in patients whom carotid endarterectomy or carotid artery stenting wasperformed. Stroke, death, hypotension, transient ischemic attack, intracranialhemorrhage, amourasis fugax, hyperperfusion syndrome, bradicardia, dissection,hematoma, aneurysm, wound infection, myocard infarctus, hypertension, cranial nerveparalysis and asystole were taken into account as complications.Results. Significant differences in early complications such as stroke, hypotension andbradicardia were detected between the two groups. No significant difference wasobserved by means of death, transient ischemic attack, intracranial hemorrhage,hyperperfusion syndrome, dissection, hematoma, wound infection, hypertension, cranialnerve paralysis and asystole. Amourasis fugax, aneurysm and myocard infarctus werenot seen in either groups.Conclusion. When early complications were taken into account, carotid artery stentingprocedure is not safer than carotid endarterectomy and does not provide better results.With the improving instrumental technology and the usage of the devices protectingagainst embolism, carotid artery stenting will provide better results in all patient groups.New studies with greater numbers which will define the patients who will benefit fromcarotid artery stenting rather than carotid endarterectomy are required.