Carotid Artery Stenting versus Endarterectomy

The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) compared the outcomes of carotid-artery stenting with those of carotid endarterectomy among over 2500 patients with symptomatic or asymptomatic extracranial carotid stenosis.
The authors offer the following conclusions:

  • Stroke was more likely after carotid artery stenting.
  • Myocardial infarction was more likely after carotid endarterectomy, but the effect on the quality of life was less than the effect of stroke.
  • Younger patients had slightly fewer events after carotid-artery stenting than after carotid endarterectomy; older patients had fewer events after carotid endarterectomy.
  • The low absolute risk of recurrent stroke suggests that both carotid-artery stenting and carotid endarterectomy are clinically durable and may also reflect advances in medical therapy.

Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis
NEJM May 26 2010 Published Online