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).
  
  
  CONCLUSIONS
  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).
authors.affiliation: Creighton University Medical Center, Omaha, NE, USA.
authors.forename: Shipra
authors.initials: S
authors.lastname: Arya
authors.forename: Iraklis I
authors.initials: II
authors.lastname: Pipinos
authors.forename: Nitin
authors.initials: N
authors.lastname: Garg
authors.forename: Jason
authors.initials: J
authors.lastname: Johanning
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Lynch
authors.forename: G Matthew
authors.initials: GM
authors.lastname: Longo
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002340:Carotid Artery Diseases / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome