Comparative analysis of the effectiveness of carotid endarterectomy operations with stenting of the carotid arteries: a systematic review

Abstract

More than ten international randomized trials have been conducted to determine the effectiveness and safety of carotid artery stenting and comparing the latter with the results of carotid endarterectomy. However, some of them obtained conflicting data confirming both the advantage of carotid stenting (SAPPHIRE) and carotid endarterectomy (EVA-3S), as well as the equivalence of the two treatments (CAVATAS, SPACE, CREST). Also, unsatisfactory results of both single-stage and staged surgical approaches were shown in the treatment of patients with combined atherosclerotic lesions of the coronary and carotid arteries. The lack of clear international guidelines for the management of patients with lesions of several vascular beds makes it necessary to look for new methods of surgical treatment based on minimally invasive endovascular technologies. This review article analyzes the results of randomized trials comparing the results of carotid endarterectomy and carotid stenting in patients with carotid atherosclerosis.