Carotid endarterectomy (CEA) is once again recommended for symptomatic patients with ipsilateral severe (70%-99%) or moderate (50%-69%) carotid stenosis (Class I; Level of Evidence A and B, respectively).1 Carotid artery stenting (CAS) is once again "indicated as an alternative to CEA for symptomatic patients"1; however, this is now a Class Ha (not a Class I) recommendation.1 Furthermore, a new recommendation was added suggesting that "it is reasonable to consider patient age in choosing between CAS and CEA."1 CEA might be associated with improved outcomes compared with CAS for patients >70 years, and for younger patients the two procedures are equivalent (Class Ila; Level of Evidence B).
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