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A 75-year-old woman with chronic obstructive pulmonary disease, type 2 diabetes, hyperlipidemia, and mild renal impairment is hospitalized for a transient ischemic attack. Imaging confirms ≥70% stenosis of the left internal carotid artery without high-risk anatomic features. Surgical risk is calculated as moderate. The hospital has teams with experience in both carotid endarterectomy and stenting. Which revascularization approach should the clinician recommend? A vascular surgeon and an interventional neuroradiologist weigh in.
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I learned that both are effective at preventing recurrent strokes in symptomatic patients, but carotid stenting has a higher risk of periprocedural death or stroke. No wonder multiple cardiology and neurology s…