Response to Letter by Pelz and Lownie Regarding Article, “Intracranial Hemorrhage Is Much More Common After Carotid Stenting Than After Endarterectomy: Evidence From the National Inpatient Sample”

Abstract

Response: We thank Drs Pelz and Lownie for their thoughtful comments regarding our recent publication in Stroke .1 We share their concern that carotid artery stenting may be associated with an excess risk of intracranial hemorrhage (ICH). The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) investigators have reported, among 2500 study participants who underwent carotid revascularization, nearly equivalent safety and efficacy of carotid artery stenting and carotid endarterectomy. However, even well-designed prospective randomized studies such as CREST face sample size limitations. In the case of rare events such as …