Outcome After 7 Years of Carotid Artery Stenting and Endarterectomy in Sweden - Single Centre and National Results

Objectives: The aim was internal vascular centre quality-control measures to compare single-centre results with the national perspective, as well as analysing the Swedish results from carotid artery stenting (CAS) and comparing a relatively high-volume single centre with the Swedish Vascular Registry (Swedvasc) data. The second aim was to compare CAS and carotid artery endarterectomy (CEA) outcomes for the same 7-year period. Design: Retrospective review of a single high-volume centre (Sodersjukhuset (SOS)) (approximately 30 CAS year(-1) approximately 90 CEA year(-1)) versus Swedvasc National data. Materials and methods: All consecutive selective patients treated with CAS at SOS for a stenosis of the internal carotid artery (n = 208) or CEA (n = 552) between 2004 and 2011 were compared with all patients in Swedvasc registered for CAS (n = 258) and CEA (n = 6474). Primary outcome was 30-day frequency of stroke or death. Secondary outcome was stroke/death/acute myocardial infarction (AMI). Results: The 30-day frequency of any stroke or death after CAS at SOS compared to the national data was 2.9% and 7.4%, respectively (P = 0.04). The 30-day AMI/stroke/death frequency was 3.4% and 9.5%, respectively (P = 0.01). After CEA during the same time period, the Swedvasc national data had a 4.4% frequency of 30-day stroke and death and 5.8% for AMI/stroke/death. Conclusions: CAS is not as safe as CEA from a national perspective but our results indicate that a single centre can achieve acceptable results with CAS. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.