Carotid Stenting vs. Endarterectomy — More Confusion Than Clarity

The EVA-3S trial was stopped early, after an interim analysis showed that 30-day risk for stroke or death was significantly higher with stenting.

In a previously published randomized U.S. trial (“SAPPHIRE”), patients with carotid stenosis and high perioperative risk underwent either carotid endarterectomy (CEA) or carotid-artery stenting with embolic protection. One-month and 1-year outcomes with stenting were at least as good as outcomes with CEA (Journal Watch Oct 29 2004).

Now, we have results from a multicenter, randomized French trial (“EVA-3S”), in which researchers enrolled patients with recent nondisabling stroke or transient ischemic attack (TIA) plus carotid stenosis ≥60%. Patients underwent either CEA or stenting, with embolic protection devices deployed in 92% of stented patients. The investigators used five different stents and seven different protection devices during th…

Reviewing Author

Allan S. Brett, MD

Carotid Stenting vs. Endarterectomy — More Confusion Than Clarity

Topics

Reviewing Author