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Carotid Stenosis Truths Upended by New NEJM Study
James Meschia/LinkedIn
Nov 22, 2025, 10:18

Carotid Stenosis Truths Upended by New NEJM Study

Evandro Martins, Interventional Cardiologist at the Holy House of Mercy, shared a post by Michael Gibson on X:

”Medicine keeps reminding us how temporary our “truths” are.
Today’s NEJM data: in high-grade carotid stenosis without recent symptoms, stenting lowered 4-year stroke/death vs intensive medical therapy, while endarterectomy didn’t show a significant benefit.
Guidelines, dogmas, and routines… all provisional.
We’re always just catching up with the evidence.”

Quoting Michael Gibson’s post:

”Among patients with high-grade stenosis without recent symptoms, the addition of stenting led to a lower risk of a composite of perioperative stroke or death or ipsilateral stroke within 4 years than intensive medical management alone. Carotid endarterectomy did not lead to a significant benefit.”

Read the full article here.

Title: Medical Management and Revascularization for Asymptomatic Carotid Stenosis

Authors: Thomas G. Brott, George Howard, Brajesh K. Lal, Jenifer H. Voeks, Tanya N. Turan, Gary S. Roubin, Ronald M. Lazar, Robert D. Brown, John Huston III, Lloyd J. Edwards, Michael Jones, Wayne M. Clark, Ángel Chamorro, Laura Llull, Carlos Mena-Hurtado, Donald Heck, Randolph S. Marshall, Virginia J. Howard, Wesley S. Moore, Kevin M. Barrett, Bart M. Demaerschalk, Navdeep Sangha, Herbert Aronow, Malcolm Foster, Charles Sternbergh III, Fayaz Shawl, Giuseppe Lanzino, Joseph Rapp, Hoang S. Tran, Robert Ecker, Ariane Mackey, Vaqar Ali, Curtis Given II, Philip Teal, Vikram S. Kashyap, Dipankar Mukherjee, Mark Harrigan, Scott Silverman, Matthew Koopmann, Virginia G. Wadley, Yu Zhang, J. David Rhodes, Seemant Chaturvedi, James F. Meschia

Carotid Stenosis

 

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Ángel Chamorro Ariane Mackey Asymptomatic Carotid Stenosis Bart M. Demaerschalk Brajesh K. Lal Carlos Mena-Hurtado Carotid Stenosis Charles Sternbergh III Curtis Given II Dipankar Mukherjee Donald Heck Evandro Martins Fayaz Shawl Gary S. Roubin George Howard Giuseppe Lanzino Health Hematology Hemostasis Hemostasis Today Herbert Aronow Hoang S. Tran J. David Rhodes James F. Meschia Jenifer H. Voeks John Huston III Joseph Rapp Kevin M. Barrett Laura Llull Lloyd J. Edwards Malcolm Foster Mark Harrigan Matthew Koopmann Medical Management Medicine Michael Gibson Michael Jones Navdeep Sangha NEJM Neurology New England Journal of Medicine Philip Teal Randolph S. Marshall revascularization Robert D. Brown Robert Ecker Ronald M. Lazar Scott Silverman Seemant Chaturvedi Tanya N. Turan Thomas G. Brott thrombosis Vaqar Ali Vikram S. Kashyap Virginia G. Wadley Virginia J. Howard Wayne M. Clark Wesley S. Moore Yu Zhang
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