Optimal Treatment of Asymptomatic Carotid Stenosis

The jury is still out.

In studies conducted more than 25 years ago, a modest benefit was seen with carotid endarterectomy relative to medical therapy for patients with 60% to 99% asymptomatic internal carotid artery stenosis. However, observational studies have shown that with advances in medical therapy, including widespread statin use, the stroke rate with medical treatment has been reduced. Therefore, it is unclear if carotid revascularization is still beneficial. These authors conducted a two-arm, randomized trial: They compared carotid endarterectomy (CEA) plus best medical therapy (BMT) with BMT alone, and separately compared carotid artery stenting (CAS) plus BMT with BMT alone. Eligible patients were between 50 and 85 years old and had stenosis ≥70%. The …

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

Optimal Treatment of Asymptomatic Carotid Stenosis

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Reviewing Author