The evidence for carotid stenting versus carotid endarterectomy in symptomatic patients

Large randomized trials have demonstrated the value of surgical intervention for symptomatic carotid artery disease in stroke prevention. More recently trials have also demonstrated benefit in asymptomatic patients. However, the benefit of surgery comes with significant burden in terms of a risk of...

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Bibliographic Details
Published in:European journal of radiology 2006-10, Vol.60 (1), p.8-10
Main Author: Gaines, P.A.
Format: Article
Language:English
Subjects:
Blood Vessel Prosthesis - statistics & numerical data
Carotid artery stenting
Carotid endartrectomy
Carotid Stenosis - epidemiology
Carotid Stenosis - surgery
Clinical Trials as Topic - statistics & numerical data
Endarterectomy, Carotid - statistics & numerical data
Evidence
Evidence-Based Medicine - statistics & numerical data
Humans
Practice Patterns, Physicians
Prevalence
Risk Assessment - methods
Risk Factors
Stents - statistics & numerical data
Stroke prevention
Treatment Outcome
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Summary:Large randomized trials have demonstrated the value of surgical intervention for symptomatic carotid artery disease in stroke prevention. More recently trials have also demonstrated benefit in asymptomatic patients. However, the benefit of surgery comes with significant burden in terms of a risk of both stroke at the time of procedure and other complications. Less invasive endovascular techniques might reduce this complication rate whilst proving as effective as surgery. At the time of writing conclusive evidence is still being sought but a Cochrane meta-analysis has indicated that with the current knowledge based on randomised trials the neuro-embolic complication rate at 30 days is equivalent between the two therapies. Endovascular techniques have fewer non-neuroembolic complications.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2006.05.022