Carotid Endarterectomy Versus Stenting for the Treatment of Patients With Carotid Artery Stenosis: An Updated Systematic Review and Meta-Analysis

Abstract

Carotid endarterectomy (CEA) is a surgical procedure that treats the narrowed carotid arteries, which may be narrowed by atherosclerosis. Stenting is the insertion of a wire mesh scaffold into the narrowed portion of the carotid artery to keep it open by preventing blood from clotting. Using the study done over 10 years back as a point of reference, this study will seek an update on an assessment comparing CEA and stenting in studies carried out between 2015 and to date. The PICOS (population, intervention, control, outcome, and study designs) criteria were used to construct a set of inclusion and exclusion guidelines. This meta-analysis and systematic review used two forms of investigative analysis; both quantitative and qualitative assessments. From the studies, stroke (95% CI: 0.51-0.71, P < 0.001), myocardial infarction (95% CI: 1.49-3.42, P = 0.001), and stroke or death analysis (95% CI: 0.53-0.77, P < 0.001) were noted to be significant. From the analysis, CEA was observed as having better treatment results in terms of stroke events and stroke or death incidences when compared to stenting. Carotid stenting was observed as having lower cases of myocardial infarctions when compared to endarterectomy.

Carotid endarterectomy for the management of carotid stenosis occurring concurrently with head and neck cancer

“…Patients who underwent CEA had higher rates of myocardial infarction, and those who had stenting had higher rates of stroke [25]. A recent systematic review and meta-analysis by Vasavada et al evaluated the literature since the CREST trial was published and showed similar findings; CEA resulted in decreased rates of stroke and composite rates of stroke or death, but higher rates of myocardial infarction compared with CAS [26 ▪ ]. Specifically for patients with CAS after cervical radiation, studies have continued to show that CEA offers improved long term outcomes regarding risk of cerebrovascular events and restenosis [27].…”

Neoatherosclerosis And Paleoatherosclerosis: Complications After Stenting

“…effects of stents and CEA are similar (Vasavada et al, 2023). To fight their related risks, the new variants of drug-eluting stents were developed, that are thinner and made of biocompatible polymers.…”

How to Penetrate the Wall of an Unintentionally Deployed Wallstent in the External Carotid Artery for Stenting of an Internal Carotid Artery Lesion

“…2 Vasavada et al presented an update on carotid intervention with systematic review and meta-analysis offering a current perspective on the comparative effectiveness of CEA and CAS. 3 The Wallstent is a stent usually crafted from a thin and flexible biocompatible metal alloy, commonly stainless steel or nitinol (a nickel-titanium alloy). It is designed as a meshlike structure with high flexibility, allowing it to adapt to the shape of the vessel or passage it is placed in.…”