Document Detail

Carotid stenting versus endarterectomy.
MedLine Citation:
PMID:  22248323     Owner:  NLM     Status:  MEDLINE    
Since the landmark NASCET and ECST trials demonstrated the superiority of carotid endarterectomy over medical therapy in the prevention of stroke for patients with symptomatic carotid artery stenosis, surgical intervention as a part of secondary prevention of stroke has become widespread. However, the newer technology of carotid artery angioplasty and stenting challenges this mode of intervention, promising the benefits of a procedure under local anesthesia and potentially avoiding the surgical complications of cranial nerve palsy and hematoma. Pooled evidence from randomized controlled trials of endarterectomy versus stenting shows a higher rate of stroke or death in the stenting groups-but this finding is mitigated to an extent by the lower incidence of myocardial infarction and cranial nerve palsy in patients undergoing stenting. At present, carotid endarterectomy combined with optimal drug therapy remains the standard of care for symptomatic 70%-99% stenosis of the internal carotid artery, but stenting might be an option in younger patients and in those not suitable for endarterectomy.
David Doig; Martin M Brown
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Annual review of medicine     Volume:  63     ISSN:  1545-326X     ISO Abbreviation:  Annu. Rev. Med.     Publication Date:  2012  
Date Detail:
Created Date:  2012-01-17     Completed Date:  2012-05-15     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  2985151R     Medline TA:  Annu Rev Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  259-76     Citation Subset:  IM    
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MeSH Terms
Angioplasty / methods,  mortality*
Carotid Stenosis* / mortality,  surgery,  therapy
Endarterectomy, Carotid / methods,  mortality*
Postoperative Complications / mortality*
Risk Factors
Stents / statistics & numerical data*
Grant Support
G0300411//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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