Abstract
Stroke is one of the leading causes of death in Russia and the world, and carotid stenosis is the leading cause of
ischemic strokes. The number of Russians who suffered a stroke exceeds 1 million people, 30% of them are people
under retirement age. Of these, only 25% of patients return to work. Male mortality from stroke in Russia exceeds
that in the Nordic countries by 2 times, in North America – by 8 times. In patients with symptomatic stenosis of the
carotid arteries, prevention of stroke is carotid endarterectomy or stenting of the carotid arteries, as well as optimal
drug therapy. The review article is devoted to the comparative evaluation of the results of carotid endarterectomy,
stenting and drug therapy according to various randomized studies.
References
- Koennecke H.C., Belz W., Berfelde D., Endres M.,
Fitzek S., Hamilton F. et al. Berlin Stroke Register
Investigators factors influencing in-hospital mortality
and morbidity in patients treated on a stroke. Neurology.
2011; 77 (10): 965–72. DOI: 10.1212/WNL.0b013e31822dc795
-
Parfenov V.A., Khasanova D.R. Ishemic stroke.
Moscow; 2012 (in Russ.).
-
Andrew N.E., Thrift A.G., Cadilhac D.A. The prevalence,
impact and economic implications of atrial fibrillation
in stroke: what progress has been made?
Neuroepidemiology. 2013; 40 (4): 227–39. DOI:
10.1159/000343667
-
Kritikou P., Spengos K., Zakopoulos N., Tountas Y.,
Fantopoulos J.Y., Vemmos K. Resource utilization and
costs for treatment of stroke patients in an acute stroke
unit in Greece. Clin. Neurol. Neurosurg. 2016; 142: 8–14.
DOI: 10.1016/j.clineuro.2015.12.013
-
Skvortsova V.I. Reduction of morbidity, mortality and
disability from insulin in the Russian Federation. Zhurnal
Nevrologii I Psikhiatrii imeni S.S. Korsakova (S.S. Korsakov
Journal of Neurology and Psychiatry). 2007;
Appendix: Stroke. Special issue: 25–8 (in Russ.).
-
Suslina Z.A., Varakin Yu.Ya., Vereshchagin N.V.
Vascular diseases of the brain: Epidemiology. Basics of
prevention. Moscow; 2009 (in Russ.).
-
Lee W.C., Joshi A.V., Wang Q., Pashos C.L., Christensen
M.C. Morbidity and mortality among elderly.
Americans with different stroke subtypes. Adv. Ther.
2007; 24 (2): 258–68. DOI: 10.1007/bf02849893
-
Marsh E.B., Llinas R.H., Schneider A.L., Hillis A.E.,
Lawrence E., Dziedzic P. et al. Predicting hemorrhagic
transformation of acute ischemic stroke: Prospective validation
of the HeRS Score. Medicine (Baltimore). 2016;
95 (2): e2430. DOI: 10.1097/MD.0000000000002430
-
Samorodskaya I.V., Zayratyants O.V., Perkhov V.I.,
Andreev E.M., Vaisman D.Sh. Trends in stroke mortality
rates in Russia and the USA over a 15-year period. Arkhiv
Patologii (Archive of Pathology). 2018; 80 (2): 30–7 (in
Russ.). DOI: 10.17116/patol201880230-37
-
Starodubov V.I. Trends in the state of public health and
prospects for the development of health care in Russia.
Moscow; 2012 (in Russ.).
-
Centers for disease control and prevention. Stroke facts.
2017. Available at: www.cdc.gov/stroke/facts.htm
(accessed 19 January 2019).
-
Shah R., Wilkins E., Nichols M. Epidemiology report:
trends in sex-specific cerebrovascular disease mortality in
Europe based on WHO mortality. Eur. Heart J. 2018;
epub ahead of press. DOI: 10.1093/eurheartj/ehy378
-
World Health Organization. The World Health Report
2002 – reducing risks, promoting healthy life. Geneva:
WHO, 2002. DOI: 10.1016/j.agecon.2003.11.006
-
Ricotta J.J., Aburahma A., Ascher E., Eskandari M.,
Faries P., Brajesh K. et al. Updated Society for Vascular
Surgery guidelines for management of extracranial
carotid disease. J. Vasc. Surg. 2011; 54: 832–6. DOI:10.1016/j.jvs.2011.07.004
-
Naylor A.R., Ricco J.B. Editor's choice – management
of atherosclerotic carotid and vertebral artery disease:
2017 clinical practice guidelines of the European Society
for Vascular Surgery (ESVS). Eur. J. Vasc. Endovasc. Surg.
2018; 55 (6): 902. DOI: 10.1016/j.ejvs.2018.03.023
-
Halliday A., Harrison M., Hayter E., Kong X., Mansfield
A., Marro J. et al. 10-year stroke prevention after
successful carotid endarterectomy for asymptomatic
stenosis (ACST-1): a multicentre randomised trial.
Lancet. 2010; 376: 1074–84. DOI: 10.1016/s0140-6736(10)61197-x
-
You R.X., Thrift A.G., McNeil J.J., Davis S.M.,
Donnan G.A. Ischemic stroke risk and passive exposure
to spouses' cigarette smoking. Melbourne Stroke Risk
Factor Study (MERFS) Group. Am. J. Public. Health.
1999; 89: 572–5. DOI: 10.2105/ajph.89.4.572
-
Jing J., Meng X., Zhao X., Liu L., Wang A., Pan Y. et al.
Dual antiplatelet therapy in transient ischemic attack and
minor stroke with different infarction patterns subgroup
analysis of the CHANCE randomized clinical trial.
JAMA Neurol. 2018; 75: 711–9. DOI: 10.1001/jamaneurol.2018.0247
-
Illuminati G., Schneider F., Pizzardi G., Masci F.,
Calio' F.G., Ricco J.-B. Dual antiplatelet therapy does
not increase the risk of bleeding after carotid endarterectomy:
results of a prospective study. Ann. Vasc. Surg. 2017;
40: 39–43. DOI: 10.1016/j.avsg.2016.09.012
-
Beneficial effect of carotid endarterectomy in symptomatic
patients high with grade stenosis. N. Engl. J. Med. 1991;
325: 445–53. DOI: 10.1056/NEJM199108153250701
-
AbuRahma A.F., Srivastava M., Stone P.A., Mousa A.Y.,
Jain A., Dean L.S. et al. Critical appraisal of the carotid
duplex consensus criteria in the diagnosis of carotid
artery stenosis. J. Vasc. Surg. 2011; 53: 53–60. DOI:
10.1016/j.jvs.2010.07.045
-
Nederkoom P.J., van der Graaf Y., Hunink M.G. Duplex
ultrasound and magnetic resonance angiography compared
with digital subtraction angiography in carotid
artery stenosis: a systematic review. Stroke. 2003; 34:
1324–32. DOI: 10.1161/01.STR.0000068367.08991.A2
-
Yuan C., Mitsumori L.M., Ferguson M.S., Polissar N.L.,
Echelard D., Ortiz G. et al. In vivo accuracy of multispectral
magnetic resonance imaging for identifying
lipid-rich necrotic cores and intraplaque hemorrhage in
advanced human carotid plaques. Circulation. 2001; 104:
2051–6. DOI: 10.1161/hc4201.097839
-
Mas J.L., Trinquart L., Leys D., Albucher J.-F.,
Rousseau H., Viguier A. et al. Endarterectomy versus
angioplasty in patients with symptomatic severe carotid
stenosis (EVA-3S) trial: results up to 4 years from a randomised,
multicentre trial. Lancet Neurol. 2008; 7:
885–92. DOI: 10.1016/s1474-4422(08)70195-9
-
Ringleb P.A., Allenberg J. 30 day results from the SPACE
trial of stent-protected angioplasty versus carotid
endarterectomy in symptomatic patients: a randomised
non-inferiority trial. Lancet. 2006; 368: 1239–47. DOI:
10.1016/s0140-6736(06)69122-8
-
Ederle J., Dobson J. Carotid artery stenting compared
with endarterectomy in patients with symptomatic
carotid stenosis (International Carotid Stenting Study):
an interim analysis of a randomised controlled trial.
Lancet. 2010; 375: 985–97. DOI: 10.1016/S1474-4422(10)70058-2
-
Yadav J.S., Wholey M.H., Kuntz R.E., Fayad P.,
Katzen B.T., Mishkel G.J. et al. Protected carotid-artery
stenting versus endarterectomy in high-risk patients.
N. Engl. J. Med. 2004; 351: 1493–501. DOI: 10.1056/NEJMoa040127
-
Silver F.L., Mackey A., Clark W.M. Safety of stenting and
endarterectomy by symptomatic status in the Carotid
Revascularization Endarterectomy versus Stenting Trial
(CREST). Stroke. 2011; 42: 675–80. DOI: 10.1161/strokeaha.110.610212
-
Paraskevas K.I., Kalmykov E.L., Naylor A.R.
Stroke/death rates following carotid artery stenting and
carotid endarterectomy in contemporary administrative
dataset registries: a systematic review. Eur. J. Vasc.
Endovasc. Surg. 2016; 51: 3–12. DOI: 10.1016/j.ejvs.2015.06.050
-
Vincent S., Eberg M., Eisenberg M.J. Meta-analysis of
randomized controlled trials comparing the long-term
outcomes of carotid artery stenting versus endarterectomy.
Circ. Cardiovasc. Qual. Outcomes. 2015; 8: S99–108.
DOI: 10.1161/circoutcomes.115.001933
-
Zhang L., Zhao Z., Ouyang Y., Bao J., Lu Q., Feng R. et
al. Systematic review and meta-analysis of carotid artery
stenting versus endarterectomy for carotid stenosis: a
chronological and worldwide study. Medicine (Baltimore).
2015; 94: e1060. DOI: 10.1097/md.0000000000001060
-
Lokuge K., de Waard D.D., Halliday A., Gray A.,
Bulbulia R., Mihaylova B. Meta-analysis of the procedural
risks of carotid endarterectomy and carotid artery
stenting over time. Br. J. Surg. 2018; 105: 26–36. DOI:
10.1002/bjs.10717
-
Kakkos S.K., Kakisis I., Tsolakis I.A., Geroulakos G.
Endarterectomy achieves lower stroke and death rates
compared with stenting in patients with asymptomatic
carotid stenosis. J. Vasc. Surg. 2017; 66: 607–17. DOI:
10.1016/j.jvs.2017.04.053
-
Moresoli P., Habib B., Reynier P., Secrest M.H.,
Eisenberg M.J., Filion K.B. Carotid stenting versus
endarterectomy for asymptomatic carotid artery stenosis
a systematic review and meta-analysis. Stroke. 2017; 48:
2150–7. DOI: 10.1161/strokeaha.117.016824
-
Hicks C.W., Nejim B., Dakour-Aridi H. Transfemoral
carotid artery stents should be used with caution in
patients with asymptomatic carotid artery stenosis. Ann.
Vasc. Surg. 2019; 54: 1–11. DOI: 10.1016/j.avsg.2018.10.001
-
Dakour-Aridi H., Locham S., Nejim B., Malas M.B.
Comparison of 30-day readmission rates and risk factors
between carotid artery stenting and endarterectomy.
J. Vasc. Surg. 2017; 66: 1432–44.e7. DOI: 10.1016/j.jvs.2017.05.09
-
ACST-2 Collaborative Group, Halliday A., Bulbulia R.,
Gray W., Naughten A., den Hartog A., Delmestri A. et al.
Status update and interim results from the Asymptomatic
Carotid Surgery Trial-2 (ACST-2). Eur. J. Vasc.
Endovasc. Surg. 2013; 46: 510–8. DOI: 10.1016/j.ejvs.2013.07.020
-
Bulbulia R., Halliday A. The Asymptomatic Carotid
Surgery Trial-2 (ACST-2): an ongoing randomised controlled
trial comparing carotid endarterectomy with
carotid artery stenting to prevent stroke. Health Technol.
Assess. 2017; 21: 1–40. DOI: 10.3310/hta21570
-
Eckstein H.H., Reiff T., Ringleb P., Jansen O.,
Mansmann U., Hacke W. et al. SPACE-2: A missed
opportunity to compare carotid endarterectomy,
carotid stenting, and best medical treatment in patients
with asymptomatic carotid stenoses. Eur. J. Vasc.
Endovasc. Surg. 2016; 51: 761–5. DOI: 10.1016/j.ejvs.2016.02.005
-
Lal B.K., Meschia J.F., Brott T.G. Clinical need, design,
and goals for the Carotid Revascularization and Medical
Management for Asymptomatic Carotid Stenosis trial.
Semin. Vasc. Surg. 2017; 30: 2–7. DOI: 10.1053/j.semvascsurg.2017.04.004
-
European Carotid Surgery Trial-2. Protocol Summary.
2015. Available at: http://s489637516.websitehome.co.uk/
ECST2/protocolsummary.htm (accessed 19 January
2019). DOI: 10.1186/isrctn97744893
-
Kwolek C.J., Jaff M.R., Leal J.I., Hopkins L.N.,
Shah R.M., Hanover T.M. et al. Results of the ROADSTER
multicenter trial of transcarotid stenting with
dynamic flow reversal. J. Vasc. Surg. 2015; 62: 1227–34.
DOI: 10.1016/j.jvs.2015.04.460
-
Malas M.B., Dakour-Aridi H., Wang G.J., Kashyap V.S.,
Motaganahalli R.L., Eldrup-Jorgensen J. et al.
Transcarotid artery revascularization versus transfemoral
carotid artery stenting in the society for vascular surgery
vascular quality initiative. J. Vasc. Surg. 2019; 69:
92–103.e2. DOI: 10.1016/j.jvs.2018.05.011
-
Ballotta E., Toniato A., Farina F., Baracchini C. The
perioperative outcomes of eversion carotid endarterectomy
in diabetic patients aged 80 years or older. J. Vasc.
Surg. 2016; 64: 348–53. DOI: 10.1016/j.jvs.2016.01.052
-
Avgerinos E.D., Go C., Ling J. Survival and long-term
cardiovascular outcomes after carotid endarterectomy in
patients with chronic renal insufficiency. Ann. Vasc. Surg.
2015; 29: 15–21. DOI: 10.1016/j.avsg.2014.07.029
-
Lindsay A.C., Biasiolli L., Lee J.M., Kylintireas I.,
MacIntosh B.J., Watt H. et al. Plaque features associated
with increased cerebral infarction after minor stroke and
TIA: a prospective, case-control, 3-T carotid artery MR
imaging study. JACC Cardiovasc. Imaging. 2012; 5:
388–96. DOI: 10.1016/j.jcmg.2011.10.007
-
Yoshimura S., Yamada K., Kawasaki M., Asano T.,
Kanematsu M., Takamatsu M. et al. High intensity signal
on time-of-flight magnetic resonance angiography indicates
carotid plaques at high risk for cerebral embolism.
Stroke. 2011; 42: 3132–7. DOI: 10.1161/strokeaha.111.615708
-
Paraskevas K.I., Veith F.J., Ricco J.B. Best medical treatment
alone may not be adequate for all patients with
asymptomatic carotid artery stenosis. J. Vasc. Surg. 2018;
68: 572–5. DOI: 10.1016/j.jvs.2018.02.046
-
Park Y.J., Kim D.I., Kim G.M., Kim D.K., Kim Y.
Natural history of asymptomatic moderate carotid artery
stenosis in the era of medical therapy. World Neurosurg.
2016; 91: 247–53. DOI: 10.1016/j.wneu.2016.04.037
-
Bogiatzi C., Cocker M.S., Beanlands R., Spence J.D.
Identifying high-risk asymptomatic carotid stenosis.
Expert Opin. Med. Diagn. 2012; 6: 139–51. DOI:
10.1517/17530059.2012.662954
-
Singh T.D., Kramer C.L., Mandrekar J., Lanzino G.,
Rabinstein A.A. Asymptomatic carotid stenosis: risk of
progression and development of symptoms. Cerebrovasc.
Dis. 2015; 40: 236–43. DOI: 10.1159/000439179
About the authors
- Leo A. Bockeria, Academician of RAS and RAMS, Director, orcid.org/0000-0002-6180-2619
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Ramiz A. Abdulgasanov, Dr. Med. Sc., Chief Researcher, orcid.org/0000-0002-2126-3139
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Nidal A. Darvish, Cand. Med. Sc., Head of Department, orcid.org/0000-0002-2152-4730
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Mukhamed A. Shogenov, Cardiovascular Surgery, orcid.org/0000-0002-9467-3729