Endarteriëctomie gunstiger dan stent bij symptomatische carotisstenose
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hoger risico op CVA of overlijden na stentplaatsing
Stand van zaken
31-01-2011
Robbert Meerwaldt, Roland J. Beuk, Ad B. Huisman, Sanne M. Manschot, Clark J. Zeebregts en Robert H. Geelkerken

Endarterectomy more favourable than stenting in symptomatic significant carotid stenosis: higher risk of ischaemic stroke or death following stenting

Conflict of interest: none declared. Financial support: none declared.

  • Carotid endarterectomy (CEA) has proven its value in the treatment of patients with recent significant carotid artery stenosis.

  • Percutaneous transluminal angioplasty with carotid artery stenting (‘stenting’ in short) is an alternative to CEA.

  • The results of stenting and CEA in patients with symptomatic significant carotid artery stenosis were evaluated in 9 prospective randomized controlled trials and 11 meta-analyses. Almost all of these trials failed to show superiority of stenting to CEA.

  • According to the 4 largest and most recent studies in this field the risk of a stroke or death within 30 days after the intervention is considerably higher following stenting than following CEA.

  • In the long run the results of stenting and CEA seem to be comparable.

  • CEA remains the gold standard in treatment of significant carotid artery stenosis, in particular in patients older than 70.