Key result
Carotid endarterectomy plus medical management is significantly better than medical management alone for stroke prevention in patients with severe carotid stenosis, while angioplasty remains an option for high-risk patients.
Why the study?
Does carotid endarterectomy or percutaneous carotid angioplasty improve stroke prevention in patients with severe carotid stenosis compared to medical management or each other?
Does carotid endarterectomy or percutaneous carotid angioplasty improve stroke prevention in patients with severe carotid stenosis compared to medical management or each other?
Carotid endarterectomy remains the standard for severe carotid stenosis, while carotid angioplasty and stenting is a viable alternative for patients at high surgical risk.
Several large randomized clinical trials in North America and Europe concluded over a decade ago that carotid endarterectomy plus medical management was significantly better than medical management alone for stroke prevention in either symptomatic or asymptomatic patients with severe carotid stenosis. Percutaneous carotid angioplasty now represents another treatment option that currently seems most appropriate either in the context of prospectively randomized trials or for patients who are at a higher than average risk for conventional surgical treatment.
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Norman Hertzer (2009) conducted a review in Carotid stenosis. Carotid endarterectomy (CEA) and percutaneous carotid angioplasty (PCA) vs. Medical management alone was evaluated. Carotid endarterectomy plus medical management is significantly better than medical management alone for stroke prevention in patients with severe carotid stenosis, while angioplasty remains an option for high-risk patients.
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