TY - JOUR
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
AU - Lynch, Thomas G.
AU - Longo, G. Matthew
PY - 2011/8
Y1 - 2011/8
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).
KW - carotid angioplasty and stenting
KW - carotid artery disease
KW - carotid endarterectomy
KW - meta-analysis
KW - systematic review
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U2 - 10.1177/1538574411407083
DO - 10.1177/1538574411407083
M3 - Article
C2 - 21646236
AN - SCOPUS:80051744676
SN - 1538-5744
VL - 45
SP - 490
EP - 498
JO - Vascular and Endovascular Surgery
JF - Vascular and Endovascular Surgery
IS - 6
ER -