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European Heart Journal 2008 29(1):7-9; doi:10.1093/eurheartj/ehm530
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Published by Oxford University Press on behalf of the European Society of Cardiology 2008

Symptomatic carotid artery stenosis: the dilemma for a reasonable selection of carotid stenting or endarterectomy

Patrice Bergeron

Department of Thoracic and Cardiovascular Surgery, Hôpital Saint Joseph, 26, bd de Louvain, Marseille 13285, Cedex 08, France

Corresponding author. Tel: +33 49180 69 05, fax: +33 49180 69 26. Email: pbergeron@hopital-saint-joseph.fr; endovasc@hopital-saint-joseph.fr

This editorial refers to ‘Safety of carotid artery stenting for symptomatic carotid artery disease: a meta-analysis’ by H.S. Gurm et al., on page 113

Footnotes

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology. Back

{dagger} doi:10.1093/eurheartj/ehm362 Back

The first 10% of the full text of this article appears below.

An excellent meta-analysis from Gurm et al.1 updates the data concerning the treatment of symptomatic carotid stenosis by a surgical or endovascular approach.

The last two randomized trials, SPACE2 and EVA3S,3 did not, in fact, confirmed the equivalence of the two methods and there followed a general unfavourable feeling towards carotid stenting. The article by Gurm et al., 1 which eliminates some old randomized studies such as CAVATAS4 and the stopped Leicester trial,5 appears statistically sound.

We can learn that . . . [Full Text of this Article]

A conflicting situation

Are the current trials relevant?

Risk factors to consider

Is the plaque structure a determining factor?

Which patients for CAS?


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Related articles in EHJ:

Safety of carotid artery stenting for symptomatic carotid artery disease: a meta-analysis
Hitinder S. Gurm, Brahmajee K. Nallamothu, and Jay Yadav
EHJ 2008 29: 113-119. [Abstract] [FREE Full Text]