Abstract T MP85: Comparison Of Carotid Endarterectomy And Carotid Artery Stenting On Asymptomatic Internal Carotid Artery Stenosis Of Japanese Male: A Propensity Score Matched Analysis
Objective: The nation-wide mortality and morbidity of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on asymptomatic internal carotid artery stenosis in Japanese have not been clear. We thus examined the comparison of CEA and CAS from a nationwide survey in Japan.
Methods: Certified neurosurgical training institutions in Japan provided data from the DPC database on patients hospitalized with neurosurgical diseases between April 1, 2012 and March 31, 2013. Patients hospitalized owing to asymptomatic internal carotid artery stenosis (ICS) for male patients were identified from the DPC database based on the International Classification of Diseases (ICD)-10 diagnosis code (I65). We excluded patients with emergency admissions. We compared the mortality rates, modified Rankin Scale (mRS) scores, and postoperative complications who underwent CEA and CAS based on propensity score matching. A propensity-matched cohort was constructed with CEA group and CAS group matched on a 1:1 basis by a nearest neighbor matching method within a caliper 0.05 SD of the propensity score for age, Charlson score, BMI and admission conscious level.
Result: We identified 2216 patients with asymptomatic ICS (1381 CAS and 835 CAS cases). After propensity matching, Patient characteristics (age, hypertension, DM , hyperlipidemia, smoking and Charlson score) were well balanced between two groups. Patients who underwent CAS had a significantly lower number of complications than patients who underwent CEA (delta= -9.74; P < 0.001).Length of hospital stay was significantly shorter for CAS group. (delta= -9.90; P < 0.001). 30 day mortality and mRS at discharge were not significantly different between two groups.
Conclusions: Our results estimate the baseline national rates of outcomes in patients with asymptomatic ICS that were treated with CAS or CEA in Japan. CAS treated group showed lower complication rates compared to CEA treated group.
Author Disclosures: K. Nishimura: None. A. Nishimura: None. R. Kurogi: None. S. Kamitani: None. A. Kada: None. T. Sayama: None. K. Iihara: None.
- © 2015 by American Heart Association, Inc.