Related Experiment Video

Updated: Jun 10, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Are symptomatic patients appropriate candidates for carotid artery stenting? No (at least not at present)

Kosmas I Paraskevas1, Dimitri P Mikhailidis, Frank J Veith

  • 1Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.

Vascular
|July 21, 2010
PubMed

Insights

Most symptomatic patients should avoid carotid artery stenting (CAS) due to higher risks and costs compared to carotid endarterectomy (CEA). CEA offers better outcomes and is more cost-effective for these individuals currently.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Health Economics

Background:

  • Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are procedures to prevent stroke in symptomatic patients.
  • The comparative effectiveness and cost-efficiency of CAS versus CEA remain critical considerations in clinical decision-making.

Purpose of the Study:

  • To evaluate the current appropriateness of carotid artery stenting (CAS) for symptomatic patients.
  • To compare the risks, recurrence rates, and costs associated with CAS versus carotid endarterectomy (CEA).

Main Methods:

  • Review of existing clinical data and cost-effectiveness analyses comparing CAS and CEA in symptomatic patients.
  • Analysis of stroke rates, recurrent stenosis rates, and economic factors for both procedures.

Main Results:

  • Carotid artery stenting (CAS) is associated with higher rates of stroke and recurrent stenosis compared to carotid endarterectomy (CEA) in symptomatic patients.
  • CAS is significantly more expensive than CEA.
  • Current evidence suggests CEA is a superior option for most symptomatic individuals.

Conclusions:

  • Carotid artery stenting (CAS) is not currently recommended for the majority of symptomatic patients.
  • Carotid endarterectomy (CEA) remains the preferred, safer, and more cost-effective intervention for these patients at present.

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