Carotid endarterectomy is superior to carotid angioplasty and stenting for perioperative and long-term results

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: Carotid angioplasty and stenting (CAS) has challenged carotid endarterectomy (CEA) as the therapy of choice for carotid disease. This meta-analysis aims at summarizing the most current body of evidence. Methods: All prospective, controlled clinical trials comparing CEA versus CAS were included. The outcome measures of interest were relative risk (RR) of 30-day stroke, 30-day stroke/death, long-term risk of stroke, and risk of restenosis. Results: The RR of 30-day stroke for CAS was 1.6 times that of CEA (RR 1.6; 95%CI 1.2-2.0, P =.001). The 30-day RR of stroke/death was 1.5 times higher for CAS (RR 1.5; 95%CI 1.1-2.1, P =.008). There was a higher risk of long-term stroke (RR 1.2; 95%CI 1.0-1.5, P =.043). The risk of restenosis was twice for CAS (RR 1.8; 95%CI 1.1-3.1, P =.04). Conclusion: The 30-day RR of stroke, stroke/death, long-term risk of stroke, and risk of restenosis are consistently higher for carotid artery stenting (CAS).

Original languageEnglish (US)
Pages (from-to)490-498
Number of pages9
JournalVascular and Endovascular Surgery
Volume45
Issue number6
DOIs
StatePublished - Aug 1 2011

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Carotid Endarterectomy
Angioplasty
Stroke
Controlled Clinical Trials
Carotid Arteries
Meta-Analysis

Keywords

  • carotid angioplasty and stenting
  • carotid artery disease
  • carotid endarterectomy
  • meta-analysis
  • systematic review

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Carotid endarterectomy is superior to carotid angioplasty and stenting for perioperative and long-term results",
abstract = "Objective: Carotid angioplasty and stenting (CAS) has challenged carotid endarterectomy (CEA) as the therapy of choice for carotid disease. This meta-analysis aims at summarizing the most current body of evidence. Methods: All prospective, controlled clinical trials comparing CEA versus CAS were included. The outcome measures of interest were relative risk (RR) of 30-day stroke, 30-day stroke/death, long-term risk of stroke, and risk of restenosis. Results: The RR of 30-day stroke for CAS was 1.6 times that of CEA (RR 1.6; 95{\%}CI 1.2-2.0, P =.001). The 30-day RR of stroke/death was 1.5 times higher for CAS (RR 1.5; 95{\%}CI 1.1-2.1, P =.008). There was a higher risk of long-term stroke (RR 1.2; 95{\%}CI 1.0-1.5, P =.043). The risk of restenosis was twice for CAS (RR 1.8; 95{\%}CI 1.1-3.1, P =.04). Conclusion: The 30-day RR of stroke, stroke/death, long-term risk of stroke, and risk of restenosis are consistently higher for carotid artery stenting (CAS).",
keywords = "carotid angioplasty and stenting, carotid artery disease, carotid endarterectomy, meta-analysis, systematic review",
author = "Shipra Arya and Pipinos, {Iraklis I} and Nitin Garg and Johanning, {Jason M} and Lynch, {Thomas G.} and Longo, {G Matthew}",
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T1 - Carotid endarterectomy is superior to carotid angioplasty and stenting for perioperative and long-term results

AU - Arya, Shipra

AU - Pipinos, Iraklis I

AU - Garg, Nitin

AU - Johanning, Jason M

AU - Lynch, Thomas G.

AU - Longo, G Matthew

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Objective: Carotid angioplasty and stenting (CAS) has challenged carotid endarterectomy (CEA) as the therapy of choice for carotid disease. This meta-analysis aims at summarizing the most current body of evidence. Methods: All prospective, controlled clinical trials comparing CEA versus CAS were included. The outcome measures of interest were relative risk (RR) of 30-day stroke, 30-day stroke/death, long-term risk of stroke, and risk of restenosis. Results: The RR of 30-day stroke for CAS was 1.6 times that of CEA (RR 1.6; 95%CI 1.2-2.0, P =.001). The 30-day RR of stroke/death was 1.5 times higher for CAS (RR 1.5; 95%CI 1.1-2.1, P =.008). There was a higher risk of long-term stroke (RR 1.2; 95%CI 1.0-1.5, P =.043). The risk of restenosis was twice for CAS (RR 1.8; 95%CI 1.1-3.1, P =.04). Conclusion: The 30-day RR of stroke, stroke/death, long-term risk of stroke, and risk of restenosis are consistently higher for carotid artery stenting (CAS).

AB - Objective: Carotid angioplasty and stenting (CAS) has challenged carotid endarterectomy (CEA) as the therapy of choice for carotid disease. This meta-analysis aims at summarizing the most current body of evidence. Methods: All prospective, controlled clinical trials comparing CEA versus CAS were included. The outcome measures of interest were relative risk (RR) of 30-day stroke, 30-day stroke/death, long-term risk of stroke, and risk of restenosis. Results: The RR of 30-day stroke for CAS was 1.6 times that of CEA (RR 1.6; 95%CI 1.2-2.0, P =.001). The 30-day RR of stroke/death was 1.5 times higher for CAS (RR 1.5; 95%CI 1.1-2.1, P =.008). There was a higher risk of long-term stroke (RR 1.2; 95%CI 1.0-1.5, P =.043). The risk of restenosis was twice for CAS (RR 1.8; 95%CI 1.1-3.1, P =.04). Conclusion: The 30-day RR of stroke, stroke/death, long-term risk of stroke, and risk of restenosis are consistently higher for carotid artery stenting (CAS).

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