title: [Stenting vs. surgery for symptomatic carotid stenosis].
abstract: Stenting is associated with a higher periprocedural risk of stroke compared to surgery. This higher stroke risk mainly concerns patients older than 70 years, whereas risk seems to be similar in patients younger than 70 years. After the procedural period, both surgery and stenting seem to be as effective to prevent stroke. Surgery remains the first choice intervention in patients with severe symptomatic carotid stenosis. It is reasonable to consider stenting in patients with contraindications to surgery due to technical or anatomical aspects, or in patients at high risk of complications because of comorbidities, after a multidisciplinary discussion. Stenting could also be considered in patients who have low risk of stroke after stenting (e.g., patients younger than 70 years). When a revascularization is indicated, intervention should be done within 2 weeks of the index event after TIA or moderate stroke.
authors.affiliation: Centre hospitalier Sainte-Anne, université Paris-Descartes, service de neurologie, centre de psychiatrie et neurosciences, Inserm UMR 894, 75014 Paris, France. Electronic address: d.calvet@ch-sainte-anne.fr.
authors.forename: David
authors.initials: D
authors.lastname: Calvet
authors.affiliation: Centre hospitalier Sainte-Anne, université Paris-Descartes, service de neurologie, centre de psychiatrie et neurosciences, Inserm UMR 894, 75014 Paris, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Mas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods