Kfoury Elias, Leng David, Hashemi Homayoun, Mukherjee Dipankar
1Inova Fairfax Hospital, Department of Surgery, Falls Church, VA, USA.
Vasc Endovascular Surg. 2013 Nov;47(8):599-602. doi: 10.1177/1538574413505227. Epub 2013 Sep 26.
Carotid artery stenting (CAS) was presented by carotid revascularization endarterectomy versus stenting trial as a minimally invasive approach with less risk of postoperative myocardial infarction (MI) when compared to carotid endarterectomy (CEA). Our study aimed to compare the postoperative MI rate for CAS with CEA under general anesthesia (GA) and local anesthesia (LA). A retrospective study was conducted at our institution comparing CAS with CEA under LA and CEA under GA. Thirty-day postoperative MI and strokes were evaluated for the different subgroups. A total of 1127 procedures were included in the analysis: 421 CEAs under GA, 611 CEAs under LA, and 95 CAS. No significant difference in postoperative MI was encountered between CAS and CEA under LA (0.2% vs 1.1%, P = .25). The CEA under GA was found to have a statistically significant higher risk of MI compared to LA (1.2% vs 0.2%, P = .044). Our evidence suggests that CEA under LA does not have an increased risk of MI compared to CAS.
颈动脉血管重建内膜切除术与支架置入术试验提出，与颈动脉内膜切除术 (CEA) 相比，颈动脉支架置入术 (CAS) 是一种微创方法，术后心肌梗死(MI)风险较小。我们的研究旨在比较全身麻醉 (GA) 和局部麻醉 (LA) 下 CAS 与 CEA 的术后 MI 发生率。我们机构进行了一项回顾性研究，比较了 LA 下的 CAS 与 CEA 以及 GA 下的 CEA。对不同亚组的术后 30 天 MI 和中风情况进行了评估。分析共纳入 1127 例手术：421 例 GA 下的 CEA、611 例 LA 下的 CEA 和 95 例 CAS。LA 下的 CAS 与 CEA 术后 MI 无显著差异(0.2% 对 1.1%，P = 0.25)。与 LA 相比，GA 下的 CEA 被发现 MI 风险在统计学上显著更高(1.2% 对 0.2%，P = 0.044)。我们的证据表明，与 CAS 相比，LA 下的 CEA 不会增加 MI 风险。
