Journal article

Comparative Effectiveness of Carotid Endarterectomy vs Initial Medical Therapy in Patients With Asymptomatic Carotid Stenosis

Salomeh Keyhani, Eric M Cheng, Katherine J Hoggatt, Peter C Austin, Erin Madden, Paul L Hebert, Ethan A Halm, Ayman Naseri, Jason M Johanning, Danielle Mowery, Wendy W Chapman, Dawn M Bravata

JAMA Neurology | AMER MEDICAL ASSOC | Published : 2020

Abstract

Importance: Carotid endarterectomy (CEA) among asymptomatic patients involves a trade-off between a higher short-term perioperative risk in exchange for a lower long-term risk of stroke. The clinical benefit observed in randomized clinical trials (RCTs) may not extend to real-world practice. Objective: To examine whether early intervention (CEA) was superior to initial medical therapy in real-world practice in preventing fatal and nonfatal strokes among patients with asymptomatic carotid stenosis. Design, Setting, and Participants: This comparative effectiveness study was conducted from August 28, 2018, to March 2, 2020, using the Corporate Data Warehouse, Suicide Data Repository, and other ..

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