Carotid Stenting Versus Surgery for Stroke Prevention

Although both studies were similar, the disparity may be explained by three main differences in the study design, the CREST researchers noted. ICSS included practice lead-in stenting cases in the results, used multiple models of stents, and included fewer cases using distal protection devices.

“In the CREST study, lead-in practice cases were not included in the trial results. Additionally, we used the same stents [for all patients], 98% of which had distal protection devices,” Dr. Clark said.

“Whether it is t-PA given after three hours or carotid stenting, US and European trials can have conflicting results,” he concluded. “I feel you should base your treatment decisions on the trial that best represents the population of patients you will be treating.”