Overview of Primary and Secondary Analyses From 20 Randomised Controlled Trials Comparing Carotid Artery Stenting With Carotid Endarterectomy

AIM: To compare carotid endarterectomy (CEA) with carotid artery stenting in 20 randomised controlled trials (RCTs), this review's primary and secondary objectives were to: (CAS).

Result : In seven RCTs with 3467 asymptomatic patients (OR 1.64, 95% confidence interval [CI] 1.02-2.64) and ten RCTs with 5797 symptomatic patients (OR 1.71, 95% CI 1.38-2.11) the 30 day death/stroke rate was substantially greater after CAS compared with CEA. At 9 years, late ipsilateral stroke was around 4% for both CEA and CAS, excluding procedural hazards, indicating that CAS was durable. Better case selection, such as performing CEA in symptomatic patients over the age of 70, within 14 days of the onset of symptoms, and in situations where the risk of stroke after CAS is anticipated to be higher (segmental/remote plaques, plaque length greater than 13 mm, heavy burden of white matter lesions [WMLs], and situations where two or more stents may be necessary), may reduce procedural death and stroke after CAS.

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