Carotid endarterectomy is superior to carotid angioplasty and stenting for perioperative and long-term results.

Authors :: Arya S
Pipinos II
Garg N
Johanning J
Lynch TG
Longo GM
Source :: Vascular and endovascular surgery [Vasc Endovascular Surg] 2011 Aug; Vol. 45 (6), pp. 490-8. Date of Electronic Publication: 2011 Jun 05.
Publication Year :: 2011
Abstract: Objective: Carotid angioplasty and stenting (CAS) has challenged carotid endarterectomy (CEA) as the therapy of choice for carotid disease. This meta-analysis aims at summarizing the most current body of evidence.<br />Methods: All prospective, controlled clinical trials comparing CEA versus CAS were included. The outcome measures of interest were relative risk (RR) of 30-day stroke, 30-day stroke/death, long-term risk of stroke, and risk of restenosis.<br />Results: The RR of 30-day stroke for CAS was 1.6 times that of CEA (RR 1.6; 95%CI 1.2-2.0, P = .001). The 30-day RR of stroke/death was 1.5 times higher for CAS (RR 1.5; 95%CI 1.1-2.1, P = .008). There was a higher risk of long-term stroke (RR 1.2; 95%CI 1.0-1.5, P = .043). The risk of restenosis was twice for CAS (RR 1.8; 95%CI 1.1-3.1, P = .04).<br />Conclusion: The 30-day RR of stroke, stroke/death, long-term risk of stroke, and risk of restenosis are consistently higher for carotid artery stenting (CAS).

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