Safety and efficiency of endovascular treatment of carotid angioplasty stenting compared with carotid endarterectomy

Background: the efficacy of carotid endarterectomy (cea) has been validated by several multicentre,randomized trials. at present,comparative studies are mounting insight into the role of carotid angioplasty and stenting (cas),also optimizing patient selection based on factors identification. cas has been proposed as an alternative to cea for the treatment of carotid endarterectomy. aim: to equate the safety and efficacy of endovascular techniques i.e. cas and cea with surgery for carotid stenosis,we implemented a systematic review and meta-analysis of randomized controlled trials. methods: we recognized 8 trials randomizing a total of 2250 patients; 1123 to cea and 1127 to cas. search was made through various databases i.e.,pubmed,medline etc,to identify randomized controlled trials comparing cas with cea. to calculate the pooled odds ratios (or) and their confidence intervals,both fixed and random effects models were used. a lower value to one indicates benefit from endovascular approach. results: there was no significant difference between the treatments even with random effect model (or=1.10; 95%),also there is no difference with deaths or any stroke at 30 days (or = 1.21; 95%). but by fixed effect model,a significantly higher death/stroke risk were estimated (or,1.11; 95%) after cas. conclusion: treating carotid endarterectomy with cas suggests lower rates of cranial nerve injury in comparison to cea. cas may perhaps not be verified,to be as nonviolent as cea in treating carotid endarterectomy.