Stenting and endarterectomy: similar

CREST: Stenting and endarterectomy show similar net safety and efficacy for carotid stenosis

FEBRUARY 26, 2010 | Susan Jeffrey

From Medscape Medical News—a professional news service of WebMD

San Antonio, TX - Final results of the long-awaited Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) show similar net outcomes with carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the treatment of carotid stenosis, researchers report [1]. The results were presented here at the American Stroke Association International Stroke Conference 2010.

On the composite primary end point of any stroke, MI, or death during the periprocedural period or ipsilateral stroke on follow-up, stenting was associated with a 7.2% rate of these events vs 6.8% with surgery, a nonsignificant difference.

However, individual risks varied, they found. At 30 days, the rate of stroke was significantly higher with stenting, at 4.1% vs 2.3% with surgery. Major stroke, though, was not different, at less than 1% in both groups. Conversely, MI was higher with carotid endarterectomy, at 2.3% vs 1.1% with stenting, again a statistically significant difference.

Patients who had an MI, however, reported a better quality of life after recovery than those who had a stroke, the authors noted.

Rates of ipsilateral stroke during a mean follow-up of 2.5 years were equal between groups, at 2.0% for stenting and 2.4% with surgery./.../