Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicentre trial

Carotid Artery Stenting in Clinical Practice: Does Sex Matter? Results From the Carotid Artery Stenting Registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

“…Thus, an increased risk for stroke or death in women undergoing CEA seems to graduate the overall risk in women in comparison with CAS in the EVA-3S trial. 12 To be able to terminally define the indications for CAS, and find eligible patients who will have a low risk for periprocedural complications, it is necessary to evaluate further data from ongoing randomized clinical trials comparing state-of-the-art procedures for CAS.…”

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive summary

“…The clinical durability of CEA and CAS beyond 5 years cannot be clearly determined from available studies. 45,171 Restenosis after CEA has been reported in 5% to 10% of cases when assessed by postoperative ultrasonography but consistently in fewer than 5% of cases when patching was used in recent series. 63,176,[276][277][278][279][280][281] Hemodynamically significant recurrent stenosis rates of 5% to 7% have been reported in multicenter trials.…”

Choice and Selection of Treatment Modalities for Cardiac Patients: An Interventional Cardiology Perspective

“…Unlike CEA, CAS is the modality of choice among patients with “hostile neck” or those with radiotherapy or prior surgical interventions in this area. The French Endarterectomy Versus Angioplasty in Patients With Severe Symptomatic Carotid Stenosis (EVA‐3S) trial demonstrated a higher rate of death or stroke at 1‐ and 6‐month follow‐up with CAS as compared to CEA, among patients with symptomatic carotid stenosis 40. The German counterpart Stent‐Protected Angioplasty versus Carotid Endarterectomy (SPACE) trial failed to demonstrate noninferiority of CAS in comparison to CEA during short‐term follow‐up 41.…”

“…Furthermore, there is ongoing controversy regarding the role of operator experience while comparing CAS and CEA, along with differing certification requirements for the 2 interventions. The rate of periprocedural stroke among symptomatic patients undergoing CAS was 6% in the CREST trial as compared to 9.6% in the EVA‐3S trial,40, 43 emphasizing the importance of training, credentialing, and auditing the CAS operators.…”