Carotid endarterectomy versus carotid angioplasty cui bono.

OBJECTIVES: To evaluate the current status of carotid angioplasty (CAS) versus carotid endarterectomy (CEA) in the management of patients with carotid bifurcation disease. DESIGN: Retrospective review of published and presented prospective randomized trials to date, regarding comparative results of CAS versus CEA. MATERIALS: Review of six published prospective randomized trials, one trial presented in press, and one trial completed and being analyzed. Large population based studies and a comparative registry study are also included. METHODS: Retrospective literature review. RESULTS: The results today favor CEA over CAS with respect to stroke morbidity, mortality, freedom from recurrence, and cost. CONCLUSIONS: At the present time, CEA remains the intervention of choice in the management of carotid bifurcation disease.