On limitations of studies and limitations of therapy options for carotid stenosis: why play golf with only a sand wedge?

摘要

I am grateful for having the chance to edit this issue of Neuroradiology focused on intra- and extracranial stenting directly after and in response to the publication of ICSS [1] and presentation of CREST [2]-two major randomised controlled trials (RCTs) comparing carotid endarterectomy (CEA) and carotid artery stenting (CAS). The results and more so, the interpretation of these studies may have a substantial impact on the neuroradiological community. Based on this data pooled with other RCTs, it has been advocated that "routine use of CAS in patients with recent symptoms of carotid stenosis who are suitable for endarterectomy can no longer be justified" [3]. This carefully worded statement leaves some room for interpretation, particularly in regard to what "suitable for endarterectomy" means.