Long-Term Outcome After Carotid Artery Stenting

Carotid artery stenting (CAS) is a less invasive technique than carotid endarterectomy (CEA) for prevention of stroke in patients with carotid artery stenosis. Although reports from high-volume centers have demonstrated acceptable short-term results after CAS, randomized controlled trials (RCT) have demonstrated inferior results, in terms of stroke and death in the perioperative phase, after CAS compared with CEA. A sustained benefit of CEA, compared with CAS, after long-term follow-up was observed in the RCTs. However, excluding the perioperative period, there has been little difference in outcomes between CEA and CAS in the RCTs. Little is known about the long-term results after CAS outside the RCTs, and consequently the generalizability of these observations has been questioned, and a recent Cochrane review pointed out the need for long-term outcome data after CAS. Population-based, nonselected cohorts can provide additional evidence. Our aim was to assess population-based, nationwide, longterm outcomes after CAS when compared with CEA during the same time period.