Meta-analysis: Carotid artery stenting has similar long-term outcomes as endarterectomy but at the cost of more perioperative strokes

Clinical Question

In adults with asymptomatic carotid stenosis, is stenting as effective and safe as endarterectomy?

Bottom line

In this systematic review, while composite outcomes are similar in adults with asymptomatic carotid stenosis who undergo CAS or CEA, the short-term stroke risk is higher in those undergoing CAS. These data reinforce the need for local complication data — if you practice in an area where the complication rate of these procedures is greater than the stroke risk, either don’t refer at all or send your patient elsewhere. 1a-

Study design: Meta-analysis (randomized controlled trials)

Funding: Self-funded or unfunded

Setting: Various (meta-analysis)

Reviewer

Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI


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Comments

ARUP KUMAR DHARA

Impact assessment

Excellent