Current Treatment Options in Neurology

, Volume 12, Issue 6, pp 475–482

Management of Stenosis of the Extracranial Internal Carotid Artery: Endarterectomy Versus Angioplasty and Stenting

Commentary

DOI: 10.1007/s11940-010-0092-7

Cite this article as:
Barrett, K.M. & Brott, T.G. Curr Treat Options Neurol (2010) 12: 475. doi:10.1007/s11940-010-0092-7

Opinion statement

Recent randomized clinical trial data support the safety and efficacy of carotid artery stenting and carotid endarterectomy for treatment of symptomatic and asymptomatic carotid occlusive disease. Endarterectomy is more effective in preventing stroke, but this may be countered by a higher risk of perioperative myocardial infarction. Age is an important determinant in selecting patients for either carotid endarterectomy or stenting. Patients older than 70 years achieve better outcomes with endarterectomy, and younger patients achieve better outcomes with stenting. Comparative clinical and anatomic durability of endarterectomy and stenting will require additional follow-up from recently completed trials. The efficacy of carotid revascularization compared with modern medical therapy in asymptomatic patients remains an important and unanswered clinical question.

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Neurology-Cannaday 2EMayo Clinic FloridaJacksonvilleUSA
  2. 2.Department of NeurologyMayo Clinic FloridaJacksonvilleUSA