Why the study?
Carotid artery stenosis causes 20 to 30% of strokes, motivating a review of randomized controlled trials to address the debate between endarterectomy and stenting.
This review outlines the management of atherosclerotic carotid stenosis, highlighting that both carotid endarterectomy and carotid artery stenting are viable options with comparable long-term outcomes for preventing fatal or disabling strokes.
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Both CAS and CEA remain viable options for carotid stenosis; leaves open optimal selection criteria in contemporary practice.
Stroke is the third leading cause of death and disability in the world. Carotid artery stenosis due to atherosclerosis accounts for 20 to 30% of all strokes. The patients can be asymptomatic or present with a transient ischemic attack or stroke. Diagnosis is based primarily on imaging modalities like carotid Doppler, CT (Computed tomography) angiogram, MR (Magnetic resonance) angiogram or DSA (Digital subtraction angiogram). Treatment options include optimal medical therapy, carotid endarterectomy-touted as the gold standard for treating significant carotid stenosis; and carotid artery stenting, whose safety and efficacy have undergone significant improvements due to technological advances in the field. We presented a review of the literature outlining the various aspects of atherosclerotic carotid stenosis and the findings of several randomized controlled trials conducted to settle the debate between endarterectomy and stenting for carotid stenosis.
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Dalai et al. (2021) studied this question.
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