Lessons from EVA-3S and SPACE.
Carotid endarterectomy (CEA) was established as the gold standard for treatment of carotid occlusive disease by several landmark papers published in the 1990s. With the continued trend toward less invasive therapies, carotid artery stenting (CAS) has challenged CEA for treatment of significant carotid artery disease. Several trials have now compared CEA and CAS and a subsequent Cochrane review indicated that the 30-day complication rates were equivalent. Unfortunately, comparative long-term data are still lacking. Two new trials comparing CAS with CAE in patients with symptomatic internal carotid artery disease have recently been published, but to what extent have they usefully added to the available data?
Beckett
David
D
Sheffield Vascular Institute, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
Gaines
Peter A
PA
D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D002340:Carotid Artery Diseases / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D011183:Postoperative Complications; D011361:Professional Competence; D012107:Research Design; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D020521:Stroke / Q000517:prevention & control; D016019:Survival Analysis