Effects of carotid artery stenosis treatment on blood pressure

J Neurosurg. 2012 Oct;117(4):755-60. doi: 10.3171/2012.7.JNS112198. Epub 2012 Aug 3.

Abstract

Object: The purpose of this study was to evaluate and compare the long-term effects of carotid endarterectomy (CEA) and carotid artery stenting (CAS) on blood pressure (BP).

Methods: Between January 2003 and December 2009, 134 patients underwent 145 procedures for treatment of carotid artery stenosis. Patients with at least 1 year of clinical and radiographic follow-up after treatment were included in this study. A total of 102 patients met this criterion and were placed in the CEA group (n = 59) or the CAS group (n = 43) according to their treatment. The percentage change in BP decrement and the number of patients with a normotensive BP were evaluated and compared between the groups.

Results: There were no significant differences between the groups with regard to baseline characteristics. Compared with the pretreatment BP, the follow-up BPs were significantly decreased in both groups. At the 1-year followup, the percentage change in the BP decrement was greater in the CAS group (percentage change: systolic BP 9.6% and diastolic BP 12.8%) than in the CEA group (percentage change: systolic BP 5.9% [p = 0.035] and diastolic BP = 8.1% [p = 0.049]), and there were more patients with a normotensive BP in the CAS group (46.5%) than in the CEA group (22.0%, p = 0.012).

Conclusions: Both CEA and CAS have BP-lowering effects. Carotid artery stenting seems to have a better effect than CEA on BP at the 1-year follow-up.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon*
  • Blood Pressure / physiology*
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / therapy*
  • Endarterectomy, Carotid*
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Treatment Outcome