Carotid endarterectomy (CEA) is considered the gold standard for treatment of stenosis, but carotid artery stenting (CAS) is a less invasive procedure that offers a promising alternative. Short-term data from ICASS suggest that CEA is superior to CAS; however, features of the study design may have affected the results, and long-term data are needed before conclusions can be made.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Yadav, J. S. et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N. Engl. J. Med. 351, 1493–1501 (2004).
Gurm, H. S. et al. Long-term results of carotid stenting versus endarterectomy in high-risk patients. N. Engl. J. Med. 358, 1572–1579 (2008).
International Carotid Stenting Study Investigators. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet 375, 985–997 (2010).
Eliasziw, M., Rankin, R. N., Fox, A. J., Haynes, R. B. & Barnet, H. J. Accuracy and prognostic consequences of ultrasonography in identifying severe carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. Stroke 26, 1747–1752 (1995).
Clark, W. M. for the CREST Investigators. The randomized Carotid Revascularization Endarterectomy vs Stenting Trial (CREST): primary results. Presented at the International Stroke Conference 2010.
Connors, J. J. III et al. Training, competency, and credentialing standards for diagnostic cervicocerebral angiography, carotid stenting, and cerebrovascular intervention. AJNR Am. J. Neuroradiol. 25, 1732–1741 (2004).
SPACE Collaborative Group. 30-day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomized non-inferiority trial. Lancet 368, 1239–1247 (2006).
Mas, J. L. et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N. Engl. J. Med. 355, 1660–1671 (2006).
Mas, J. L. et al. Endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis (EVA-3S) trial: results up to 4 years from a randomized, multicenter trial. Lancet Neurol. 7, 885–892 (2008).
Bonati, L. H. et al. New ischaemic brain lesions on MRI after stenting or endarterectomy for symptomatic carotid stenosis: a substudy of the International Carotid Stenting Study (ICSS). Lancet Neurol. 9, 353–362 (2010).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
S. Chaturvedi has acted as a consultant for Abbott Vascular. He was on the stroke adjudications committee of CREST and is on the executive committee of the ACT-I study. S. Narayanan declares no competing interests.
Rights and permissions
About this article
Cite this article
Narayanan, S., Chaturvedi, S. Carotid endarterectomy versus stenting—long live the king?. Nat Rev Cardiol 7, 304–305 (2010). https://doi.org/10.1038/nrcardio.2010.57
Issue Date:
DOI: https://doi.org/10.1038/nrcardio.2010.57
