Why the study?
Does carotid artery stenting reduce stroke and recurrent stenosis compared to carotid endarterectomy in symptomatic patients?
Does carotid artery stenting reduce stroke and recurrent stenosis compared to carotid endarterectomy in symptomatic patients?
Carotid endarterectomy remains the preferred treatment over carotid artery stenting for most symptomatic patients due to lower stroke risk, lower recurrent stenosis rates, and better cost-effectiveness.
Most symptomatic patients should not be candidates for carotid artery stenting (CAS); at least not at present. In these patients, CAS is associated with higher stroke, as well as recurrent stenosis rates compared with carotid endarterectomy (CEA). Furthermore, CAS is considerably more expensive than CEA. These facts raise the question, why perform CAS in symptomatic patients when you have CEA, which is associated with lower stroke and recurrent stenosis rates, and is also a more cost-effective option. This article supports the theory that currently most symptomatic patients are not appropriate candidates for CAS.
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Paraskevas et al. (2010) studied this question.
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