What is the risk of stroke, MI, or death within 30 days or ipsilateral stroke up to 12 months for CEA and CAS in symptomatic patients?
The Carotid Stenosis Trialists Collaboration evaluated 4138 patients randomly assigned to CEA or CAS. In patients who received the procedure within 1 week of the last symptomatic event, the stroke/death rate was 8.3% with CAS versus 1.3% with CEA (RR, 6.7; P=0.002). The SAPPHIRE trial (Stenting and Angioplasty With Protection in Patients at High Risk for Endarterectomy) found that among symptomatic patients, the primary end point (stroke, MI, or death within 30 days or ipsilateral stroke up to 12 months) occurred in 16.8% of patients undergoing CAS and 16.5% of patients undergoing CEA (P=0.95). However, the trial was not powered to evaluate only the symptomatic group of patients.