Carotid Endarterectomy Versus Carotid Artery Stenting Of Comparing The Efficacy And Safety For Carotid Artery Stenting:A Meta-analysis

Objective This can lead to different degrees of systemic vascular stenosis,carotid artery stenosis disease mainly because of atherosclerosis,and carotid artery stenosis can cause cerebrovascular disease,severe cases can cause stroke,the serious consequences caused by carotid endarterectomy and carotid artery stenting for the treatment of carotid artery stenosis has been widely used,but both in the treatment of carotid artery stenosis which way is more effective and has not yet made a unified conclusion by meta-analysis(Meta analysis)compared with carotid endarterectomy(CEA)and carotid artery stenting(CAS)is effective and safety in the treatment of carotid artery stenosis perioperativelly correlative complications and long-term follow-up in the process.Methods Computer retrieval of the PubMed database ? MEDLINE ?EMBASE ? Cochrane Library ? Google Scholar databases ? China Academic Journal?Chinese Biomedical Database ? WEIPU Database?Wanfang Database?CNKI Chinese HowNet ? Foreign Language Medical bio lo gical HowNet,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of carotid artery stenosis,published from building adatabase to February 28,2018.Two independent authors screened out randomized clinical trials(RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.3 software with related data.Results Elevens RCTs were included in our meta-analysis(n=9070).When we campared endarterectomy and stenting,we found CAS reduced the risk of myocardial infarction(RR,2.15;95% CI,1.41-3.29;P<0.01),cranial nerve palsy(RR,16.23;95%CI,8.76-30.09;P<0.01)and hematoma(RR,0.86;95% CI,0.61-1.20;P>0.05);But increasing the risk of any stroke(RR,0.82;95% CI,0.71-0.94;P<0.01),restenosis(RR,0.57;95% CI,0.35-0.93;P<0.05),periprocedural stroke or death(RR,0.70;95% CI,0.52-0.94;P<0.05)and death or nondisabling stroke(RR,0.63;95% CI,0.42-0.93;P<0.05).It is no statistical significance of death,death or disabling stroke,death or any stroke or myocardial infarction.During long-term follow-up,CAS is also better reduced the risk of myocardial infarction(RR,1.97;95% CI,1.25-3.09;P<0.01)and cranial nerve palsy(RR,10.00;95% CI,1.29-77.51;P<0.05)than CEA,but increasing the risk of any stroke(RR,0.82;95% CI,0.71-0.94;P<0.01)and death or nondisabling stroke(RR,0.63;95% CI,0.42-0.93;P<0.05)campared with CEA.It is no statistical significance of death,restenosis,death or any stroke,death or disabling stroke,death or any stroke or myocardial infarction and age subgroup analysis.Conclusions Althought stenting reduced the risk myocardial infarction and cranial nerve palsy,but During long-term follow-up,CAS increasd the risk of death and stroke.So,CEA treatment of carotid artery stenosis is safe and effective,it is worth to be popularized in clinic.