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Comparison of Endovascular and Open Carotid Artery Treatment in Germany: A Retrospective Analysis from 2010 to 2015

Authors
  • Freyhardt, Patrick1, 2
  • von Beckerath, Olga3
  • Dörbecker, Ralf1
  • Schott, Peter1
  • Aufmesser-Freyhardt, Birgit1
  • Katoh, Marcus1
  • Kröger, Knut3
  • 1 HELIOS Klinikum Krefeld, Department of Diagnostic and Interventional Radiology, Lutherplatz 40, Krefeld, 47805, Germany , Krefeld (Germany)
  • 2 University Witten/Herdecke, Witten, Germany , Witten (Germany)
  • 3 HELIOS Klinikum Krefeld, Department of Vascular Medicine, Lutherplatz 40, Krefeld, 47805, Germany , Krefeld (Germany)
Type
Published Article
Journal
CardioVascular and Interventional Radiology
Publisher
Springer-Verlag
Publication Date
Jan 02, 2019
Volume
42
Issue
5
Pages
657–665
Identifiers
DOI: 10.1007/s00270-018-2146-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

IntroductionWe analyzed trends in carotid artery stenting (CAS) and carotid endarterectomy (CEA) in hospitalized cases in Germany in the years 2010–2015.MethodsData from national statistics (DRG statistics) published by the Federal Statistical Office in Germany describing the number of hospitalized patients treated with CEA and CAS were used. In addition, numbers of patients hospitalized with the principal diagnosis stroke associated with precerebral lesions (ICD code I63), transitory cerebral ischemic attacks (G45) and precerebral carotid artery stenosis (I65) treated by CEA and CAS were analyzed for the year 2015.ResultsTotal number of CEA decreased by 4.0% from 24.067 (2010) to 23.104 (2015) and CAS increased by 5.1% from 5.703 to 5.992. In 2015, 79.4% of all procedures coded concerning the internal carotid artery were CEA and 21.6% CAS. From 27.798 cases hospitalized with the principal diagnosis stroke associated with precerebral lesions, CEA was performed in 3.921 (14.1%) and in 2.132 (7.7%) CAS was documented, with CAS making up one-third of all treatments within the stroke group. In 28.273 cases hospitalized with a TIA, CEA was specified in 853 (3.0%) and CAS in 255 (0.9%) cases. In 27.553 cases with an occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction, 17.036 (61.8%) had a CEA and 3.156 (11.5%) a CAS procedure.ConclusionCEA is still the primary treatment of extracranial artery stenosis. The impact of CAS becomes mainly apparent in cases presenting with acute strokes.

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