Reference : Do we need a new carotid artery stenting trial?
Scientific journals : Article
Human health sciences : Surgery
Do we need a new carotid artery stenting trial?
Van Damme, Hendrik mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Defraigne, Jean [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Acta Chirurgica Belgica
Acta Medica Belgica
Yes (verified by ORBi)
[en] Angioplasty, Balloon/adverse effects ; Carotid Stenosis/surgery/therapy ; Embolism ; Endarterectomy, Carotid/adverse effects ; Humans ; Randomized Controlled Trials as Topic ; Risk Assessment ; Stroke/epidemiology ; Treatment Outcome
[en] Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery stenting (CAS) over carotid artery endarterectomy (CEA). There is at the moment no level-I evidence to support widespread use of endovascular management of carotid artery disease in routine practice. In order to shead some light on the continuing debate on the role of carotid artery stenting, the authors conducted a search in contemporary published literature concerning carotid artery stenting. This extensive literature review reveals a higher peri-procedural stroke-death rate after CAS and a higher cost. Two other events hamper the value of CAS: a higher late restenosis rate and a higher risk of micro-embolisation during the procedure, compared with CEA. The authors conclude that the prevailing overenthusiasm of interventionalists (vascular surgeons, radiologists, cardiologists) for carotid artery stenting is not justified.

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