18 doctors weighed in:

Is stenting or carotid endarterectomy better?

18 doctors weighed in
Dr. Andris Kazmers
Surgery - Vascular
6 doctors agree

In brief: Carotid intervention

CEA has lower stroke risk than stent, stent has lower risk of MI and cranial nerve injury.
Each suitable at times. Best to go to provider that can do either. CEA generally better for standard risk patients, stent generally best if patient has had neck radiation, tracheostomy, or prior CEA. Can get biased view if provider can only do one or the other. Go to someone that can advise on risk/benefit.

In brief: Carotid intervention

CEA has lower stroke risk than stent, stent has lower risk of MI and cranial nerve injury.
Each suitable at times. Best to go to provider that can do either. CEA generally better for standard risk patients, stent generally best if patient has had neck radiation, tracheostomy, or prior CEA. Can get biased view if provider can only do one or the other. Go to someone that can advise on risk/benefit.
Dr. Andris Kazmers
Dr. Andris Kazmers
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3 doctors agree

In brief: Typically CEA

I am a vascular surgeon and preform both procedures.
Typically a carotid endarterectomy is preferred over carotid stenting unless you have had a previous carotid endarectomy, radiation therapy to the neck for cancer, a high burfication of the internal carotid artery making the surgery difficult or the patients overall health status making them to unhealthy to undergo an operation.

In brief: Typically CEA

I am a vascular surgeon and preform both procedures.
Typically a carotid endarterectomy is preferred over carotid stenting unless you have had a previous carotid endarectomy, radiation therapy to the neck for cancer, a high burfication of the internal carotid artery making the surgery difficult or the patients overall health status making them to unhealthy to undergo an operation.
Dr. Ernest Zichal
Dr. Ernest Zichal
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4 comments
Dr. Christopher White
I'm a cardiologist and would tell you that the current guidelines suggest that surgery and stent results are very similar .
Dr. Christopher White
I'm a cardiologist and would tell you that the current guidelines suggest that surgery and stent results are very similar .
Dr. Peter H'doubler
Surgery - Vascular
3 doctors agree

In brief: Endartectomy better

Carotid endartectomy (cea) is a scientifically proven, remarkably effective procedure which prevents stroke in patients with symptomatic carotid stenosis or high grade asymptomatic stenosis.
It is a very durable and long lasting procedure and has a very high success rate when performed by an experienced vascular surgeon. Stenting is only appropriate in certain, special situations.

In brief: Endartectomy better

Carotid endartectomy (cea) is a scientifically proven, remarkably effective procedure which prevents stroke in patients with symptomatic carotid stenosis or high grade asymptomatic stenosis.
It is a very durable and long lasting procedure and has a very high success rate when performed by an experienced vascular surgeon. Stenting is only appropriate in certain, special situations.
Dr. Peter H'doubler
Dr. Peter H'doubler
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Dr. Michael Korona
Radiology - Interventional
2 doctors agree

In brief: Experience

Of the operator of major importance.
I have been doing carotid stents since 1999 and have a very low stroke rate that equals or surpasses endarterectomy at my hospitals. Ask your doctor.

In brief: Experience

Of the operator of major importance.
I have been doing carotid stents since 1999 and have a very low stroke rate that equals or surpasses endarterectomy at my hospitals. Ask your doctor.
Dr. Michael Korona
Dr. Michael Korona
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2 comments
Dr. Steven Busuttil
International studies mostly show a higher risk for stroke with Carotid stenting compared to endarterectomy
Dr. Timothy Wu
Be that as it may, your personal experience is not generalized to all practitioners. As Dr. Busuttil pointed out carotid endarterectomy continues to be the standard of care in patients with carotid disease, with stenting reserved for a clear minority of cases. Your assertion that stenting is superior is irresponsible and not, even in the most liberal of interpretations, supported by the data.
Dr. Shadi Abu Halimah
Surgery - Vascular

In brief: Depends

The gold standard is carotid endarterectomy cea but mutiple studies shows that stenting is not inferior to cea.
Mutiple factors plays role in outcome including symptomatic patients where cea is better , age of the patient where cea is better in 80 years and older. People with previous cea , people with high risk disease like severe coronary artery disease or bad lungs better have stenting.

In brief: Depends

The gold standard is carotid endarterectomy cea but mutiple studies shows that stenting is not inferior to cea.
Mutiple factors plays role in outcome including symptomatic patients where cea is better , age of the patient where cea is better in 80 years and older. People with previous cea , people with high risk disease like severe coronary artery disease or bad lungs better have stenting.
Dr. Shadi Abu Halimah
Dr. Shadi Abu Halimah
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Dr. Andrew Ahn
Surgery - Vascular

In brief: Endarterectomy

I like to do surgical endarterectomy to remove the plaque rather leave it in the artery itself.

In brief: Endarterectomy

I like to do surgical endarterectomy to remove the plaque rather leave it in the artery itself.
Dr. Andrew Ahn
Dr. Andrew Ahn
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