skip to main content

CEA vs CAS – Evidence Comparison — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCerebrovascular DiseaseCEA vs CAS – Evidence ComparisonSCE Neurology

A 55-year-old man with symptomatic left carotid stenosis of 70% is being discussed at the neurovascular MDT. The interventional radiologist suggests carotid artery stenting (CAS) instead of carotid endarterectomy (CEA). What does the evidence show regarding CEA vs CAS?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — CEA remains the preferred revascularisation technique for most patients — the ICSS and CREST trials showed that CEA has a lower periprocedural risk of stroke than CAS, particularly in patients over 70

The ICSS (International Carotid Stenting Study) and CREST (Carotid Revascularization Endarterectomy versus Stenting Trial) demonstrated that CEA has a lower periprocedural risk of stroke than CAS, particularly in patients >70 years. CAS may be considered when CEA is technically difficult, in patients with significant cardiac comorbidity (general anaesthesia risk), or when the stenosis is surgically inaccessible (high cervical ICA, radiation-induced stenosis). A: CEA is superior in most patients. C: There are differences in outcomes. D: Age >70 favours CEA over CAS. E: CEA remains the gold standard.

Reference: ICSS Trial (2010); CREST Trial (2010); NICE NG128