Abstract
Stenting is associated with a higher periprocedural risk of stroke compared to surgery. This higher stroke risk mainly concerns patients older than 70 years, whereas risk seems to be similar in patients younger than 70 years. After the procedural period, both surgery and stenting seem to be as effective to prevent stroke. Surgery remains the first choice intervention in patients with severe symptomatic carotid stenosis. It is reasonable to consider stenting in patients with contraindications to surgery due to technical or anatomical aspects, or in patients at high risk of complications because of comorbidities, after a multidisciplinary discussion. Stenting could also be considered in patients who have low risk of stroke after stenting (e.g., patients younger than 70 years). When a revascularization is indicated, intervention should be done within 2 weeks of the index event after TIA or moderate stroke.
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