Carotid Artery Stenting: Verdict Still Pending

To the Editor:In their recent article, Derdeyn et al1 reviewed existing data for carotid artery stenting (CAS) in patients with asymptomatic carotid stenosis and concluded that there is no role for CAS in patients with low surgical risk and no proven benefit from carotid endarterectomy (CEA). These conclusions are categorical and strong against CAS without any possibility of “appellation” but are based on confusing data selected from literature. There are many unresolved questions in this article.The authors exclusively analyzed results from nonrandomized industry-sponsored investigational device exemption (IDE) studies, most of which specifically focusing on high-risk subgroups (ARCHeR, BEACH, SECurity). These studies were reported as existing data about CAS in “low surgical risk patients” and they …