Key result
Percutaneous carotid angioplasty is associated with a higher risk of stroke or death compared to carotid endarterectomy in symptomatic patients and those aged 70 years or older.
Why the study?
Does percutaneous carotid angioplasty compared to carotid endarterectomy reduce stroke or death in patients with severe carotid stenosis?
Does percutaneous carotid angioplasty compared to carotid endarterectomy reduce stroke or death in patients with severe carotid stenosis?
Carotid endarterectomy remains the standard of care over angioplasty/stenting for most patients with severe carotid stenosis, particularly those who are symptomatic or elderly, due to a lower risk of periprocedural stroke and death.
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 yet another treatment option that currently appears to have a higher risk than endarterectomy in symptomatic patients as well as in those who are 70 years of age or older. For these reasons, there is a consensus that angioplasty should be used cautiously in such patients and probably remains most appropriate either in the context of ongoing randomized trials or for patients who are at a higher-than-average risk for conventional surgical treatment.
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Norman Hertzer (2010) conducted a review in Carotid stenosis. Percutaneous carotid angioplasty vs. Carotid endarterectomy was evaluated. Percutaneous carotid angioplasty is associated with a higher risk of stroke or death compared to carotid endarterectomy in symptomatic patients and those aged 70 years or older.
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