Carotid Endarterectomy Versus Angioplasty : A Vascular Surgeon's Perspective

Carotid endarterectomy (CEA) is an established procedure for secondary prevention of stroke in symptomatic individuals with carotid artery stenosis of 70%-99%. The availability of cerebral angioplasty (CA) and stenting has provided another option for the management of symptomatic carotid artery stenosis, although procedural embolisation remains a significant risk. Despite the obvious advantages , such as avoidance of wound complications, cranial nerve injury and the potential for day care intervention. CA is a relatively new treatment modality and has not been subject to the same scrutiny as CEA. There is need for developing appropriate selection criteria for selecting patients for CA, based on properly conducted randomized trials.