Carotid artery stenting versus endarterectomy: What are the risks of further strokes?

This paper compared complications after carotid artery stenting and carotid endarterectomy. 

Stroke occurs when there is not enough blood supply to the brain. To prevent stroke, procedures are done to allow blood to easily flow through the carotid artery, which leads to the brain. Carotid endarterectomy is a surgical procedure where the plaque (build-up of fat) that obstructs blood flow is removed from the carotid artery. This allows blood to flow better. Carotid artery stenting is a procedure in which a mesh wire tube is inserted into the carotid artery. This opens up the narrowed blood vessel.  

Diffuse-weighted magnetic resonance imaging is a type of scan that looks at the body, and is helpful in studying stroke. It is suggested that this imaging will help to compare the safety of carotid endarterectomy and carotid artery stenting. 

The authors looked at 20 studies of carotid endarterectomy and carotid artery stenting, including 2104 patients. These studies also used diffuse-weighted magnetic resonance imaging.

Diffuse-weighted imaging identified the occurrence of brain damage from insufficient blood supply in 40.3% following coronary artery stent procedures compared with 12.2% following carotid endarterectomy procedures. Death after the procedure occurred in only 2 patients who underwent carotid artery stenting. No patients who underwent carotid artery endarterectomy died from the procedure. Patients who underwent carotid artery stenting were 2.01 times more at risk of stroke than patients who underwent carotid endarterectomy.

The authors concluded that coronary artery stenting is associated with an increased occurrence of brain damage from insufficient blood supply.

Talk to your doctor about the differences between carotid artery stenting and carotid endarterectomy.