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Updated: Jul 11, 2026
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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
[Stent and surgery for symptomatic carotid stenosis. SPACE study results]
1Neurologische Universitätsklinik, Im Neuenheimer Feld 400, 69120, Heidelberg. Peter.Arthur.Ringleb@med.uni-heidelberg.de
Der Nervenarzt
|September 13, 2007
Summary
The SPACE trial found carotid endarterectomy (CEA) and stented angioplasty (CAS) had similar effectiveness for symptomatic carotid stenosis. However, CAS showed higher rates of in-stent restenosis, suggesting CEA remains the preferred treatment.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Clinical Trials
Background:
- Symptomatic carotid artery stenosis poses a significant stroke risk.
- Carotid endarterectomy (CEA) and stented angioplasty (CAS) are treatment options.
- The SPACE trial aimed to compare these interventions.
Purpose of the Study:
- To compare the risk and effectiveness of CAS versus CEA in patients with symptomatic carotid stenosis.
- To determine if CAS is non-inferior to CEA.
Main Methods:
- A noninferiority design was used in the SPACE trial.
- 1,214 patients with symptomatic carotid stenosis were included.
- Primary endpoint: ipsilateral stroke or death between randomization and 30 days.
Main Results:
- Noninferiority of CAS to CEA was not proven (risk difference 95% CI: -1.94% to +2.87%).
- No significant differences in primary or secondary endpoints were observed between CAS and CEA.
- In-stent restenosis was significantly more common after CAS (4.6%) compared to CEA (2.2%).
Conclusions:
- Carotid endarterectomy (CEA) remains the gold standard for symptomatic carotid artery stenosis.
- Stent-supported angioplasty (CAS) may be an alternative for highly experienced interventionalists with low complication rates.
- Further evaluation of CAS long-term outcomes and restenosis rates is warranted.