Thromboembolism resulting from complex atheromatous plaque formation at the origin of the internal carotid artery is a common cause of ischemic stroke. In appropriately selected patients, plaque removal by carotid endarterectomy is of substantial net benefit. Endovascular stenting appears less 'invasive' than endarterectomy, but is the former as safe and effective as the latter?
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
Rothwell, P. M., Eliasziw, M., Gutnikov, S. A., Warlow, C. P. & Barnett, H. J. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 363, 915–924 (2004).
Brott, T. G. et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N. Engl. J. Med. 363, 11–23 (2010).
Giles, M. F. & Rothwell, P. M. Risk of stroke early after transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 6, 1063–1072 (2007).
Ederle, J., Featherstone, R. L. & Brown, M. M. Percutaneous transluminal angioplasty and stenting for carotid artery stenosis. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD000515. doi: 10.1002/14651858.CD000515.pub3 (2007).
Ederle, J. et al. 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).
Rothwell, P. M. Poor outcomes after endovascular treatment of symptomatic carotid stenosis: time for a moratorium. Lancet Neurol. 8, 871–873 (2009).
Yadav, J. S. et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N. Engl. J. Med. 351, 1493–1501 (2004).
Carotid Stenting Trialists' Collaboration. Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis: a preplanned meta-analysis of individual patient data. Lancet, 376, 1062–1073 (2010).
Schneider, P. A. & Naylor, A. R. Transatlantic debate. Asymptomatic carotid artery stenosis—medical therapy alone versus medical therapy plus carotid endarterectomy or stenting. Eur. J. Vasc. Endovasc. Surg. 40, 274–281 (2010).
Halliday, A. et al. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet 376, 1074–1084 (2010).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Sandercock, P. Carotid stenosis—surgery or stenting to prevent stroke?. Nat Rev Neurol 6, 647–648 (2010). https://doi.org/10.1038/nrneurol.2010.174
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneurol.2010.174