Retrospective review of the Southeastern Vascular Study Group between January 2011 and December 2018 Of 8303 carotid endarterectomies (CEAs) and 1876 carotid artery stenting (CAS) procedures, slightly more than half of patients were asymptomatic in each group. Symptomatic patients had significantly higher rates of in-hospital neurologic events, myocardial infarction, and death after CEA and of neurologic events after CAS than asymptomatic patients. There was no difference in mortality among symptomatic and asymptomatic male and female patients at 3 years after CEA, but asymptomatic men had significantly higher 3-year mortality than women after CAS. Long-term mortality risk in asymptomatic men should be considered before offering CAS.
