From Medscape Medical Newsa professional news service of WebMD
Stockholm, Sweden - Safety data from the International Carotid Stenting Study (ICSS), comparing carotid endarterectomy with stenting in patients with recently symptomatic carotid stenosis eligible for either procedure, shows superior results with surgery, at least at 30 days' postprocedure .
"We have provided in this randomized trial strong evidence that carotid endarterectomy is safer than carotid artery stenting in the primary intention-to-treat [ITT] analysis and also in the per-protocol analysis, where there were twice as many strokes associated with stenting as with carotid endarterectomy," principal investigator Dr Martin M Brown (University College London Institute of Neurology, UK) reported on behalf of ICSS investigators.
The difference in strokes was driven largely by nondisabling strokes associated with stenting, a finding that may have been balanced to some degree, Brown noted, by a much higher frequency of cranial nerve palsy seen with endarterectomy.
Still, he concluded, "Carotid endarterectomy is the treatment of choice for suitable patients with recently symptomatic carotid artery stenosis."
Their findings were presented at the European Stroke Conference 2009.