Vasavada Advait M, Singh Priyansha, Firdaus Arshia, Meenashi Sundaram Dakshin, Patel Malvik, Singh Ganeev, Palanisamy Logesh, Ansari Sana Afreen, Thummala Sumaina, Pandya Harsh
Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND.
Internal Medicine, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND.
Cureus. 2023 Feb 16;15(2):e35070. doi: 10.7759/cureus.35070. eCollection 2023 Feb.
Carotid endarterectomy (CEA) is a surgical procedure that treats the narrowed carotid arteries, which may be narrowed by atherosclerosis. Stenting is the insertion of a wire mesh scaffold into the narrowed portion of the carotid artery to keep it open by preventing blood from clotting. Using the study done over 10 years back as a point of reference, this study will seek an update on an assessment comparing CEA and stenting in studies carried out between 2015 and to date. The PICOS (population, intervention, control, outcome, and study designs) criteria were used to construct a set of inclusion and exclusion guidelines. This meta-analysis and systematic review used two forms of investigative analysis; both quantitative and qualitative assessments. From the studies, stroke (95% CI: 0.51-0.71, P < 0.001), myocardial infarction (95% CI: 1.49-3.42, P = 0.001), and stroke or death analysis (95% CI: 0.53-0.77, P < 0.001) were noted to be significant. From the analysis, CEA was observed as having better treatment results in terms of stroke events and stroke or death incidences when compared to stenting. Carotid stenting was observed as having lower cases of myocardial infarctions when compared to endarterectomy.
颈动脉内膜切除术(CEA)是一种治疗颈动脉狭窄的外科手术,颈动脉狭窄可能由动脉粥样硬化引起。支架置入术是将金属丝网支架插入颈动脉狭窄部位,通过防止血液凝固来保持血管通畅。以10多年前进行的研究为参考点,本研究将寻求对2015年至今开展的比较CEA和支架置入术的研究评估进行更新。采用PICOS(人群、干预措施、对照、结局和研究设计)标准构建了一套纳入和排除指南。这项荟萃分析和系统评价采用了两种调查分析形式;定量和定性评估。从研究中可以看出,中风(95%CI:0.51 - 0.71,P < 0.001)、心肌梗死(95%CI:1.49 - 3.42,P = 0.001)以及中风或死亡分析(95%CI:0.53 - 0.77,P < 0.001)具有统计学意义。分析表明,与支架置入术相比,CEA在中风事件以及中风或死亡发生率方面具有更好的治疗效果。与内膜切除术相比,观察到颈动脉支架置入术的心肌梗死病例较少。