Risk of stroke similar when treating severe carotid artery stenosis with surgery or stenting
Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are associated with a comparable long-term stroke risk, according to new findings presented at ESC Congress 2021 and published in The Lancet.
When used to treat patients with severe carotid artery stenosis, CAS and CEA have long been linked to certain procedural risks. Those risks have decreased over the years, the study’s authors noted, but disabling stroke remains a potential side effect.
To compare the two treatment options, researchers tracked data from more than 3,600 patients who underwent either CAS or CEA from Jan. 15, 2008, to Dec. 31, 2020. Patients were treated at one of 130 facilities in one of 33 different countries included in the team’s analysis. A nearly identical number of patients underwent each procedure, though some patients were moved from one group to another over the course of the study.
Overall, 1% of patients in both groups had a disabling stroke or died within 30 days of the procedure. Two percent of patients in both groups had a non-disabling procedural stroke.
The similar outcomes continued over time. After an average follow-up period of five years, for instance, fatal or disabling stroke was seen in 2.5% of patients in both groups. Non-procedural stroke was slightly more common among CAS patients (5.3%) than the CEA patients (4.5%).
“We have shown that, for patients with a severely narrowed carotid artery, stenting and surgery have similar effects on the chances of having a disabling or fatal stroke,” lead author Alison Halliday, MD, a professor at the University of Oxford, said in a statement. “The risk from each procedure is about 1%. After that, however, the annual risk over the next five or more years is halved, from 1% down to 0.5% per year.”
The full analysis is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.