Guo Z, Liu C, Huang K, et al. - As in-stent restenosis (ISR) hinders the long-term patency of carotid artery stenting (CAS), researchers here compared outcomes of re-do CAS (rCAS) and carotid endarterectomy (CEA) for ISR. The PubMed, Embase and Cochrane databases yielded a total of 11 articles with 1,057 patients receiving rCAS (n = 894) or CEA (n = 163) for inclusion. Findings suggest common use of re-do carotid artery stenting in treating patients with severe and/or symptomatic ISR after primary CAS. Despite that endovascular approach is a less invasive procedure, both rCAS and CEA can be conducted safely with similar short- and mid-term consequences of stroke, death, and surgery-related complications.