Carotid stenting there was no significant differences out to four years of follow-up between surgery and carotid stenting when counting all three, but carotid endarterectomy (CEA) has a higher risk of heart attacks and CAS has a higher risk of minor stroke than open surgery. Overall, younger patients (<70 years old) had better outcomes with stenting than with surgery. Patients had fewer heart attacks with stenting, but they did have more minor strokes. There was no difference between surgery or stenting for major (disabling) strokes. Prior to this, several European trials have reported results in symptomatic carotid artery stenosis patients comparing surgery
Carotid stenting trial. This trial showed no difference between carotid stenting and carotid surgery in average risk patients. Most recently, a broad consensus of experts released a guideline document suggesting that in most cases, carotid stenting may be considered an alternative therapy to surgery. Carotid stenting can be performed under general or local anesthesia. Critical steps in the procedure are vascular access, crossing the stenosis with a wire, deploying a stent across the lesion, and removing the vascular access. A number of other steps may or may not be performed, including the use of a cerebral protection device, pre- or post-stent balloon