Journal Article

Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis

Mas, Jean-Louis, Larrue, Vincent, Piquet, Philippe, Giroud, Maurice, Neau, Jean-Philippe, Viguier, Alain, Garnier, Pierre, Favrole, Pascal, Beyssen, Bernard, Moulin, Thierry, Touzé, Emmanuel, Albucher, Jean-François, Hosseini, Hassan, Lièvre, Michel, Watelet, Jacques, Chatellier, Gilles, Bonneville, Jean-François, Pillet, Jean-Christophe, Leys, Didier, Pruvo, Jean-Pierre, Branchereau, Alain, Becquemin, Jean-Pierre, Viader, Fausto, Ducrocq, Xavier

2006

Overview

In this randomized trial of patients with symptomatic carotid stenosis of 60% or more, patients who underwent endarterectomy had lower rates of death or stroke at 1 month and 6 months than patients who underwent stenting. In this randomized trial of patients with symptomatic carotid stenosis of 60% or more, patients who underwent endarterectomy had lower rates of death or stroke at 1 month and 6 months than patients who underwent stenting. Findings from two large randomized, clinical trials 1 – 3 have established endarterectomy as the standard treatment for severe symptomatic carotid-artery stenosis. As compared with endarterectomy, stenting avoids the need for general anesthesia and an incision in the neck that could lead to nerve injury and wound complications. The costs may be less than those of surgery, mainly because the hospital stay is shorter. However, stenting also carries a risk of stroke and local complications, and the long-term efficacy of this technique is not well known. A systematic review 4 of five randomized trials comparing stenting with endarterectomy 5 – 10 concluded that the current . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Angioplasty / Biological and medical sciences / Cardiovascular disease / Carotid Stenosis / Carotid Stenosis - mortality / Carotid Stenosis - surgery / Carotid Stenosis - therapy / Endarterectomy, Carotid / Endarterectomy, Carotid - adverse effects / Female / Follow-Up Studies / General aspects / Humans / Incidence / Life Sciences / Male / Medical imaging / Medical sciences / Myocardial Infarction / Myocardial Infarction - epidemiology / Neurology / Neurons and Cognition / Pharmaceutical sciences / Pharmacology / Risk / Stents / Stents - adverse effects / Stroke / Stroke - epidemiology / Stroke - mortality / Treatment Outcome / Vascular diseases and vascular malformations of the nervous system