Does carotid-artery stenting reduce the composite primary outcome of stroke, myocardial infarction, or death in patients with symptomatic or asymptomatic carotid stenosis compared to carotid endarterectomy?
Patients with symptomatic or asymptomatic carotid stenosis
Carotid-artery stenting
Carotid endarterectomy
Composite primary outcome of stroke, myocardial infarction, or deathcomposite
Carotid-artery stenting and carotid endarterectomy have similar overall risks for the composite of stroke, MI, or death, though stenting carries a higher periprocedural stroke risk and endarterectomy carries a higher periprocedural MI risk.
Among patients with symptomatic or asymptomatic carotid stenosis, the risk of the composite primary outcome of stroke, myocardial infarction, or death did not differ significantly in the group undergoing carotid-artery stenting and the group undergoing carotid endarterectomy. During the periprocedural period, there was a higher risk of stroke with stenting and a higher risk of myocardial infarction with endarterectomy. (ClinicalTrials.gov number, NCT00004732.)
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Thomas G. Brott
Robert W. Hobson
George Howard
New England Journal of Medicine
University of Toronto
University of Alabama at Birmingham
Oregon Health & Science University
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Brott et al. (Wed,) studied this question.
www.synapsesocial.com/papers/69d7608ff44a16d01ef30ade — DOI: https://doi.org/10.1056/nejmoa0912321