What question did this study set out to answer?

To evaluate the efficacy and clinical role of protected carotid-artery stenting compared with carotid endarterectomy in high-risk patients with carotid-artery disease.

October 6, 2004New England Journal of MedicineOpen Access

Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients

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Why the study?

Does protected carotid-artery stenting prevent stroke compared to carotid endarterectomy in high-risk patients with severe symptomatic or asymptomatic atherosclerotic carotid-artery stenosis?

Population

High-risk patients with severe symptomatic or asymptomatic atherosclerotic carotid-artery stenosis

Comparison

Protected carotid-artery stenting vs Carotid endarterectomy

Authors

JYJay S. YadavBanasthali University MWMark H. WholeyAudie L. Murphy Memorial VA Hospital RKRichard E. KuntzInterventional Cardiology

Discussion

Member takes

Implication

Supports protected stenting as alternative to endarterectomy in high-risk carotid stenosis; extends less-invasive revascularization options.

Key Points

To evaluate the efficacy and clinical role of protected carotid-artery stenting compared with carotid endarterectomy in high-risk patients with carotid-artery disease.
Assessed carotid-artery stenting performed with an emboli-protection device as an alternative to surgical carotid endarterectomy.
Targeted high-risk patients presenting with severe symptomatic or asymptomatic atherosclerotic carotid-artery stenosis.
Carotid endarterectomy provides superior prevention of stroke compared to medical management alone in patients with severe carotid stenosis.
Carotid stenting incorporating an emboli-protection device functions as a less invasive revascularization strategy than open surgical endarterectomy.

Structured PICO

Does protected carotid-artery stenting prevent stroke compared to carotid endarterectomy in high-risk patients with severe symptomatic or asymptomatic atherosclerotic carotid-artery stenosis?

Population

High-risk patients with severe symptomatic or asymptomatic atherosclerotic carotid-artery stenosis

Intervention

Protected carotid-artery stenting (stenting with the use of an emboli-protection device)

Comparator

Carotid endarterectomy

Cite This Study

Yadav et al. (2004) studied this question.

synapsesocial.com/papers/69d7608ff44a16d01ef30ae0 https://doi.org/10.1056/nejmoa040127

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Implication

Supports protected stenting as alternative to endarterectomy in high-risk carotid stenosis; extends less-invasive revascularization options.