Carotid Revascularization in Elders: Which Method Is Preferred?

A meta-analysis suggests that endarterectomy may be preferred among elders, but direct comparisons are needed.

Several clinical trials have been conducted in North America and Europe comparing carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with symptomatic carotid stenosis. One trial (CREST) also included asymptomatic patients. These authors performed a meta-analysis of published carotid stenosis treatment studies that reported age-specific data, focusing on the outcomes of these procedures in elders. They identified 44 studies that involved 512,685 CEA procedures and 75,201 CAS procedures. The studies varied in their definition of elder, typically using an age cutoff of 75 or 80 years.

CEA was associated with significantly increased 30-day mortality in older versus younger patients (0.5% vs. 0.4%; odds ratio, 1.62), a dif…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Carotid Revascularization in Elders: Which Method Is Preferred?

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Reviewing Author