Is Carotid Artery Stenting Beneficial for Asymptomatic Patients?

Signs point to no, but randomized trials await completion.

Most recent trials pertaining to carotid artery stenting (CAS) have compared CAS with carotid endarterectomy (CEA). There is a paucity of data on how CAS compares to intensive medical therapy, especially using current targets for blood pressure and lipid management. These authors conducted an analysis of patients in whom carotid imaging identified asymptomatic carotid stenosis in the Veterans Affairs (VA) system between 2005 and 2009. Of the 219,979 patients, 551 underwent CAS. The authors propensity-matched these individuals to 2509 patients who received medical therapy for asymptomatic carotid stenosis. The primary outcome was the 5-year risk for fatal or nonfatal stroke.

Among the included patients (mean age, 74 years; 99% men), the risk …

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

Is Carotid Artery Stenting Beneficial for Asymptomatic Patients?

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Reviewing Author