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Although carotid artery stenting (CAS) is less invasive than carotid endarterectomy (CEA), morbidity and mortality at 30 days were higher with stenting than with surgery in a recent randomized trial (Journal Watch Oct 18 2006). In a new meta-analysis, investigators examined 30-day outcomes with the two procedures.
Boston researchers identified 10 trials (8 randomized and 2 nonrandomized) that involved 3580 patients. Thirty-day rates of stroke or death in the larger trials ranged from about 4% to 10% among CEA patients and from about 2% to 12% among CAS patients. Thirty-day risk for stroke or death was significantly higher with CAS than with CEA (risk ratio, 1.30); for stroke alone, the risk ratio (1.27) just failed to reach significance. In …