[Carotid endarterectomy and carotid stenting: a vascular surgeon's point of view]

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Atherosclerotic stenosis of the internal carotid artery is a significant risk factor for ischemic stroke.
• Carotid endarterectomy and carotid stenting are established revascularization procedures.
• Choosing the optimal intervention requires careful consideration of patient-specific factors.

Purpose of the Study:

• To review and compare the clinical outcomes of carotid endarterectomy versus carotid stenting.
• To identify specific clinical situations where one intervention may be preferred over the other.
• To provide evidence-based guidance for treatment decisions in internal carotid artery stenosis.

Main Methods:

• Systematic literature review of comparative studies.
• Analysis of clinical trial data and observational studies.
• Evaluation of procedural success, complication rates, and long-term efficacy.

Main Results:

• Both carotid endarterectomy and carotid stenting are effective in reducing stroke risk.
• Outcomes vary based on patient anatomy, comorbidities, and lesion characteristics.
• Specific patient profiles may benefit more from surgical or endovascular approaches.

Conclusions:

• The choice between carotid endarterectomy and carotid stenting should be individualized.
• Shared decision-making between clinician and patient is crucial.
• Further research may refine indications for each procedure in specific patient subgroups.