Managing Asymptomatic Carotid Stenosis

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Source: NEJM

Original: https://www.nejm.org/doi/full/10.1056/NEJMe2515725?af=R&rss=currentIssue...

Published: 2025-11-21T03:30:00Z

The study compared the treatment of asymptomatic carotid stenosis (narrowing of the carotid artery without symptoms) using intensive medical treatment alone or in combination with revascularization (stenting or endarterectomy). In the stent arm of the study, 6.0% of patients in the medical-only group had an event (trauma, death, or ischemia on the side of the stenosis) within 4 years, compared to 2.8% in the stenting group. The difference was statistically significant. However, no significant difference between groups was found in the endarterectomy arm. The study included patients with a high degree of stenosis (70% or more) and followed them for 4 years. The results show that the addition of stenting to intensive medical treatment reduces the risk of target events compared to medical treatment alone. Endarterectomy in combination with intensive medical treatment did not provide a significant advantage.