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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

Rivista di Chirurgia Vascolare ed Endovascolare


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Italian Journal of Vascular and Endovascular Surgery 2007 December;14(4):297-300

Copyright © 2007 EDIZIONI MINERVA MEDICA

lingua: Inglese

Decision making in carotid artery stenting versus carotid endarterectomy: risk/outcome relationships

Deshmukh D. N., Illig K. A.

Division of Vascular Surgery University of Rochester Medical Center Rochester, NY, USA


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It is a fallacy to state that an endovascular approach is always less invasive than surgery and that outcomes are independent of patient risk: the morbidity and mortality of carotid artery stenting (CAS) is not independent of patient risk. Risk is a slippery subject – difficult to categorize, and even harder to quantify. We wish to stress that not only is the outcome of CAS dependent on patient risk, but also that each patient risk factor should be considered independently and affects the outcomes of carotid endarterectomy (CEA) and CAS to different degrees. There is no such thing as a “low-risk” or “high-risk” patient – rather each patient has some number of discrete factors, which influence the risk of either procedure in different ways. When deciding between CEA and CAS the practitioner should consider each patient on a case-by-case basis with particular attention paid to specific risk factors before deciding on one therapy over the other.

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