Updated Evidence on Carotid Revascularization

In a randomized trial that included both symptomatic and asymptomatic patients with substantial carotid stenosis but low stroke risk, revascularization provided no benefit over optimal medical treatment alone.

Trials conducted about three decades ago showed a benefit from carotid endarterectomy (CEA) for select patients with symptomatic stenosis in particular and also those with asymptomatic stenosis. Since then, better medical therapies — including widespread use of statins and improved blood pressure control — and surgical procedures have come into use. To provide a contemporary comparison of carotid revascularization (either CEA or carotid stenting) with optimized medical treatment, these authors conducted a randomized trial with 429 patients (31% women) seen at 30 centers between 2012 and 2019, assigning patients with at least 50% internal carotid artery stenosis and a projected 5-year stroke risk of <20% to optimized medical therapy (OMT) al…

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

Updated Evidence on Carotid Revascularization

Topics

Reviewing Author