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Volume 359:311-313 July 17, 2008 Number 3
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Carotid Stenting versus Endarterectomy

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by Gurm, H. S.
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To the Editor: Gurm and colleagues (April 10 issue)1 conclude that carotid stenting is not inferior to carotid endarterectomy in high-risk patients. This conclusion may be misleading. First, patients were at high risk not for stroke but for surgery. Second, in the absence of controls, the best strategy could have been medical therapy alone. A pooled analysis of the Asymptomatic Carotid Atherosclerosis Study2 and the Asymptomatic Carotid Surgery Trial3 shows that in patients with asymptomatic carotid artery stenosis (71% of patients randomly assigned to a study group in the Stenting and Angioplasty with Protection in Patients at High Risk for . . . [Full Text of this Article]



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