Two carotid artery approaches to prevent stroke are comparable. Carotid end arterectomyand less invasive carotid artery stenting are both effective options for treating patients at risk for stroke, according to findings from the Carotid Revas cularization Endarterectomy versus Stenting Trial, a large randomized stroke prevention trial. The trial, reported on in the July 1 New England Journal of Medicine, evaluated 2,502 patients treated at 117 medical centers in the United States and Canada. The estimated fouryearrates of early stroke, heart attack, anddeath were similar for patients undergoing either procedure. Those who received a stent had fewer heart attacks, whereas patients treated with carotid endarterectomyhad fewer strokes. Patients younger than 70 years did slightly better with stents, and those older than 70 years did better with surgery. Both procedures "are clinically durable and may also reflect advances in medical therapy," write the authors.