Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.

<h4>Background</h4>There have been inconsistent results regarding the use of carotid artery endarterectomy (CEA) versus carotid artery stenting (CAS) for contralateral carotid occlusion (CCO). This study aimed to determine the optimal revascularization technique for patients with CCO.<...

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Autores principales:	Yaxuan Sun, Yongxia Ding, Kun Meng, Bin Han, Jing Wang, Yan Han
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/31df4e9c7b9b47548c116a414fe4e2fa
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spelling	oai:doaj.org-article:31df4e9c7b9b47548c116a414fe4e2fa2021-12-02T20:05:33ZComparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.1932-620310.1371/journal.pone.0250580https://doaj.org/article/31df4e9c7b9b47548c116a414fe4e2fa2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250580https://doaj.org/toc/1932-6203<h4>Background</h4>There have been inconsistent results regarding the use of carotid artery endarterectomy (CEA) versus carotid artery stenting (CAS) for contralateral carotid occlusion (CCO). This study aimed to determine the optimal revascularization technique for patients with CCO.<h4>Methods</h4>We systematically searched the PubMed, Embase, and Cochrane Library databases to identify eligible studies published from inception to January 2, 2021. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate pooled effect estimates using a random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed.<h4>Results</h4>Six studies involving 6,953 patients were selected for inclusion in this meta-analysis. Our results showed that while CEA was not associated with an increased risk of stroke compared to CAS (OR: 1.07; 95% CI: 0.75-1.51; P = 0.713), CEA was associated with a reduced risk of death compared to CAS (OR: 0.45; 95% CI: 0.29-0.70; P < 0.001). Furthermore, there were no significant differences between CEA and CAS for the risks of myocardial infarction (OR: 1.38; 95% CI: 0.73-2.62; P = 0.319) or major adverse cardiovascular events (OR: 1.03; 95% CI: 0.56-1.88; P = 0.926). Finally, the risk of myocardial infarction for CEA versus CAS was affected by disease status, while the risk of major adverse cardiovascular events was affected by the proportions of patients with male gender, coronary artery disease, and current or prior smoking.<h4>Conclusion</h4>This study found that CEA and CAS resulted in similar outcomes for patients with CCO, while the risk of death was reduced in patients treated with CEA. Further high-level evidence should be collected to verify the results of this study.Yaxuan SunYongxia DingKun MengBin HanJing WangYan HanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0250580 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yaxuan Sun Yongxia Ding Kun Meng Bin Han Jing Wang Yan Han Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
description	<h4>Background</h4>There have been inconsistent results regarding the use of carotid artery endarterectomy (CEA) versus carotid artery stenting (CAS) for contralateral carotid occlusion (CCO). This study aimed to determine the optimal revascularization technique for patients with CCO.<h4>Methods</h4>We systematically searched the PubMed, Embase, and Cochrane Library databases to identify eligible studies published from inception to January 2, 2021. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate pooled effect estimates using a random-effects model. Sensitivity, subgroup, and publication bias analyses were also performed.<h4>Results</h4>Six studies involving 6,953 patients were selected for inclusion in this meta-analysis. Our results showed that while CEA was not associated with an increased risk of stroke compared to CAS (OR: 1.07; 95% CI: 0.75-1.51; P = 0.713), CEA was associated with a reduced risk of death compared to CAS (OR: 0.45; 95% CI: 0.29-0.70; P < 0.001). Furthermore, there were no significant differences between CEA and CAS for the risks of myocardial infarction (OR: 1.38; 95% CI: 0.73-2.62; P = 0.319) or major adverse cardiovascular events (OR: 1.03; 95% CI: 0.56-1.88; P = 0.926). Finally, the risk of myocardial infarction for CEA versus CAS was affected by disease status, while the risk of major adverse cardiovascular events was affected by the proportions of patients with male gender, coronary artery disease, and current or prior smoking.<h4>Conclusion</h4>This study found that CEA and CAS resulted in similar outcomes for patients with CCO, while the risk of death was reduced in patients treated with CEA. Further high-level evidence should be collected to verify the results of this study.
format	article
author	Yaxuan Sun Yongxia Ding Kun Meng Bin Han Jing Wang Yan Han
author_facet	Yaxuan Sun Yongxia Ding Kun Meng Bin Han Jing Wang Yan Han
author_sort	Yaxuan Sun
title	Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
title_short	Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
title_full	Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
title_fullStr	Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
title_full_unstemmed	Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
title_sort	comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/31df4e9c7b9b47548c116a414fe4e2fa
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Comparison the effects of carotid endarterectomy with carotid artery stenting for contralateral carotid occlusion.

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