Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Stroke

Carotid stenosis—surgery or stenting to prevent stroke?

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

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. 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).

    Article  CAS  Google Scholar 

  2. Brott, T. G. et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N. Engl. J. Med. 363, 11–23 (2010).

    Article  CAS  Google Scholar 

  3. 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).

    Article  Google Scholar 

  4. 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).

  5. 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).

    Article  Google Scholar 

  6. Rothwell, P. M. Poor outcomes after endovascular treatment of symptomatic carotid stenosis: time for a moratorium. Lancet Neurol. 8, 871–873 (2009).

    Article  Google Scholar 

  7. Yadav, J. S. et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N. Engl. J. Med. 351, 1493–1501 (2004).

    Article  CAS  Google Scholar 

  8. 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).

  9. 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).

    Article  CAS  Google Scholar 

  10. 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).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints 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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneurol.2010.174

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing