Surgical results and statistical modeling from clini- cal trials such as NASCET and CREST support this threshold for perioperative outcomes.24 3. On the basis of trials of antiplatelet therapy for patients with recent stroke or TIA, antiplatelet therapy is recommended for patients with symp- tomatic carotid stenosis. Similarly, antihyperten- sive therapy and statins are recommended for patients with symptomatic carotid stenosis. A recent trial of 2 different lipid targets for patients with a recent stroke or TIA found that an LDL tar- get of <70 mg/dL was associated with a reduced vascular event rate compared with a target of 90 This trial included patients with symptomatic carotid stenosis. The use of multi- modality medical therapy also has been incorpo- rated into clinical trials.18 4. The analysis by Rothwell et al369 found mild ben- efit in patients with 50% to 69% ICA stenosis (4.6% over 5 years). In the NASCET analysis of this stenosis range, there was no clear benefit of CEA seen in women and in patients with retinal ischemic events. In the combined analysis of symp- tomatic CEA trials, the number needed to treat to prevent 1 stroke was higher in women compared with men (36 versus 9). Life expectancy also should be considered when treatment decisions are made because CEA has delayed benefit. 5. Several variables have been analyzed in relation to CEA and CAS outcomes. The Carotid Stenting Trialists Collaboration analyzed outcomes in 4754 patients from 4 clinical trials.371 Within 120 days of study entry, HRs were calculated according to 5-year age intervals to compare CAS with CEA. In the group 65 to 69 years of age, the HR was 1.61 (95% CI, 0.90 2.88). 