Safety of Stenting vs. Endarterectomy for Symptomatic Carotid Stenosis

Two trials cast doubt on the safety of carotid stenting, but a final verdict awaits results of ongoing investigations.

Interest is growing in carotid artery stenting (CAS) for symptomatic patients with carotid stenosis. Two recent studies addressed whether CAS is as safe as carotid endarterectomy (CEA) in these patients.

The publicly funded, multicenter, randomized EVA-3S trial was designed to assess the noninferiority of CAS to CEA in patients with symptomatic carotid stenosis ≥60% and average surgical risk. The trial was stopped early, after enrolling 527 patients, due to a clearly higher 30-day incidence of any stroke or death with CAS than with CEA (9.6% vs. 3.9%). This difference persisted at 6 months (11.7% vs. 6.1%).

In the partly industry-funded, multicenter SPACE trial, 1200 patients with symptomatic moderate and severe carotid stenosis (≥70% by ECST…

Reviewing Author

Raul G. Nogueira, MD

Safety of Stenting vs. Endarterectomy for Symptomatic Carotid Stenosis

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Reviewing Author