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The clinical application of a scoring protocol to select endarterectomy or stenting for carotid artery stenosis

 Joonho Chung  ;  Jung-Jae Kim  ;  Yong Bae Kim  ;  Sang Hyun Suh  ;  Kyung-Yul Lee 
 SCIENTIFIC REPORTS, Vol.12(1) : 4687, 2022-03 
Journal Title
Issue Date
Carotid Stenosis* / complications ; Carotid Stenosis* / surgery ; Constriction, Pathologic / complications ; Endarterectomy, Carotid* / adverse effects ; Humans ; Stents / adverse effects ; Stroke* / complications ; Treatment Outcome
Previously we described the protocol-based decision for choosing the proper surgical treatment option for carotid stenosis. The objective of this study is to describe our experiences of using this scoring protocol in the selection of endarterectomy or stenting for carotid stenosis. Between October 2014 and March 2018, the scoring protocol was applied to a total of 105 consecutive patients. Eighty (76.2%) patients had symptomatic stenosis ≥ 50%, and 25 (23.8%) patients had asymptomatic stenosis ≥ 80%. We also speculated about how effectively the protocol worked in the real clinical setting. Stenting was performed in 73 patients and endarterectomy in 32 patients. Overall, 98 (93.3%) patients were treated according to the protocol, while the protocol was violated in seven (6.7%) patients. Sixty-one (58.1%) patients received treatments that were decided by the protocol. There were 37 (35.2%) patients who had the same score for both treatment options. Among these patients, 28 patients underwent stenting and nine patients underwent endarterectomy. In the stenting cases, 90.4% of the patients followed the protocol and violations occurred in 9.6%. In the endarterectomy cases, all of the patients followed the protocol. Overall, one patient had a procedure-related complication without morbidity. During the 12-month follow-ups, there were no restenoses or major strokes. Minor strokes were diagnosed in three (2.8%) patients. In patients with carotid artery stenosis, stenting and endarterectomy should be considered simultaneously together, not against each other. Our scoring protocol can be used to weigh these options and applied in clinical practice.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
Chung, Joon Ho(정준호)
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