Objective To compare the efficacy of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with symptomatic carotid artery stenosis (SCS) and analyze the factors influencing short-term prognosis.
Methods A total of 68 patients with SCS were retrospectively selected as the study subjects, and divided into CEA group (31 cases) and CAS group (37 cases) according to the treatment modality. The clinical efficacy, levels of biochemical indicatorstumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), superoxide dismutase (SOD), short-term prognosis (stroke, myocardial infarction, death, recurrence), and the incidence of postoperative complications (hyperperfusion syndrome, hypoperfusion syndrome, local hematoma, decreased heart rate, acute carotid artery occlusion) were compared between the two groups. Univariate and multivariate logistic regression analyses were used to screen the factors influencing poor short-term prognosis.
Results The markedly effective rate and total effective rate in the CEA group were higher than those in the CAS group, while the ineffective rate was lower than that in the CAS group, with statistically significant differences (P < 0.05). After surgery, the levels of IL-6, TNF-α, and MDA in both groups were lower than those before surgery, and the SOD level was higher than that before surgery. Moreover, the levels of IL-6, TNF-α, and MDA in the CEA group were lower than those in the CAS group, and the SOD level was higher than that in the CAS group, with statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05). There was no statistically significant difference in the incidence of stroke, myocardial infarction, and death between the two groups (P>0.05). The recurrence rate and total incidence of poor prognosis in the CEA group were lower than those in the CAS group, with statistically significant differences (P < 0.05). Univariate logistic regression analysis showed that the surgical modality, hypertension, diabetes, coronary heart disease, and smoking history were factors influencing poor short-term prognosis (P < 0.05). Multivariate logistic regression analysis showed that the surgical modality, hypertension, and coronary heart disease were independent factors influencing poor short-term prognosis (P < 0.05).
Conclusion Compared with CAS, CEA has better efficacy in the treatment of SCS, shows greater advantages in reducing systemic inflammatory response and oxidative stress response, and has a lowertotal incidence of poor prognosis. The surgical modality, hypertension, and coronary heart disease are independent factors influencing poor short-term prognosis and have independent prognostic value.
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