Touze et al reported a clinical rule for selecting a patient for carotid angioplasty and stenting (CAS) or carotid endarterectomy. The authors are from multiple institutions in Europe and the Carotid Stenting Trialists' Collaboration.
Patient selection: carotid artery stenosis
Outcome: perioperative stroke or death
Parameters for SCAR (sex, contralateral occlusion, age, restenosis):
(1) sex
(2) contralateral occlusion
(3) age in years
(4) restenosis
Parameter
Finding
Points
age
< 75 years
1
>= 75 years
0
sex
male
0
female
1
contralateral stenosis
absent
0
present
1
restenosis
absent
0
present
1
score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 2 was designated low risk (exception male >= 75 years old).
• All other patients were considered high risk.
For a high-risk patient the risk from CAS was twice that of endarterectomy.
For a low-risk patient CAS and endarterectomy had comparable risks.
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