CONTROVERSY

29. What is the role of CEA?

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Although CEA remains the standard of care for carotid artery disease, percutaneous angioplasty with stenting has been investigated as an alternative. The underlying rationale is to decrease morbidity, hospital costs, and anesthetic risks and to improve long-term patency. Reported rates of success, morbidity, and mortality run the gamut from stroke and death rates comparable to CEA (2.4%) to significantly higher neurologic risk (stroke rate, 8.8%) and higher cost. One randomized trial is currently under way in Great Britain, and applications for two other studies are being considered in the United States. Carotid angioplasty has no apparent benefit compared with CEA.

References
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BIBLIOGRAPHY
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