<International Circulation>: For patients with carotid artery stenosis, there is not general agreement on whether to select carotid artery stenting or carotid endarterectomy. Could you share your experience in this field? If the patient has asymptomatic carotid artery stenosis, would you choose stenting, best medical treatment, or surgery?
Prof. Sievert: It is still being debated, but we have positive trials comparing surgery and medical therapy showing that surgery is superior. The ACAS trial (Asymptomatic Carotid Atherosclerosis Study) and the ACST trial (Asymptomatic Carotid Surgery Trial) are two large randomized trials that have shown that the five-year stroke risk can be reduced by 50% if the patient is sent to surgery early. Therefore, I really do not understand why this debate is still ongoing.
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