Key result
CAS and CEA provide comparable long-term benefits and similar risks for severe carotid stenosis.
Why the study?
Recent advances in endovascular tools and techniques alongside recent randomized trial data have provided new insights into optimal patient selection and treatment for carotid artery stenosis.
Does carotid artery stenting or endarterectomy prevent stroke in patients with severe carotid artery stenosis?
Does carotid artery stenting or endarterectomy prevent stroke in patients with severe carotid artery stenosis?
Carotid artery stenting and endarterectomy provide comparable stroke prevention in severe carotid stenosis, with modern stenting technologies enhancing procedural safety.
Novel endovascular tools in carotid stenosis warrant prospective trials; leaves open any practice change pending randomized data.
Current management of patients with carotid artery stenosis is based on well-established guidelines, including surgical procedures - carotid endarterectomy (CEA) and endovascular carotid artery stenting (CAS) - and optimal medical treatment alone. Outcomes in the postprocedural period after CAS and CEA are similar, suggesting strong clinical durability for both treatments. Recent advances, which include the emergence of novel endovascular treatment tools and techniques, combined with more recent randomised trial data shed new light on optimal patient selection and treatment in contemporary practice. Improved, modern technologies including enhanced embolic protection devices and dual-layered micromesh stents yield better outcomes and should result in further improvements in CAS. In centres of excellence, nowadays, the majority of patients with severe carotid artery stenosis can be successfully treated with either CEA or CAS.
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Saško Kedev (2023) conducted a review in Carotid artery stenosis. Carotid artery stenting (CAS) vs. Carotid endarterectomy (CEA) was evaluated. Carotid artery stenting and carotid endarterectomy are complementary procedures that carry similar risks and provide comparable long-term benefits for patients with severe carotid artery stenosis.
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