Carotid stenosis: surgical Endarterectomy versus percutaneous Stenting
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2004 Oct 7;351(15):1493-501 Randomized Controlled Trial
IN stroke, ischemic, carotid stenosis, asymptomatic (80%) or symptomatic (50%) The Use of
carotid-artery stenting with an emboli-protection device
As Treatment, Acute
Is better Than
endarterectomy
To reduce major cardiovascular events at 1 year (death, stroke or perioperatory infarction): 12.2% stent VS 20.1% endarcterectomy, p NS
J Vasc Surg. 2011 Mar;53(3):792-7 Systematic Review
IN stroke, ischemic, carotid stenosis, asymptomatic or symptomatic (80%) The Use of
carotid artery stenting
As Treatment, Acute
Is worse Than
surgical carotid endarterectomy
To modify outcomes: stenting increased the risk of stroke (RR 1.45) and death (1.5 to 2.5), even if it reduced the risk of perioperative myocardial infarction (0.40)
Lancet Neurol. 2008 Oct;7(10):885-92 Randomized Controlled Trial
IN stroke, ischemic, carotid stenosis, symptomatic The Use of
carotid artery stenting
As Treatment, Acute
Is worse Than
carotid endarterectomy
To reduce overall frequency of early and late (at 4 years) strokes: 11% stent VS 6.2% endarterectomy, largely accounted for by the higher periprocedural (within 30 days of the procedure) stroke risk of stenting