biostudies-literatureUnknown69(1)Liu E<h4>Background</h4>The fragility index (FI) measures the robustness of randomized controlled trials (RCTs) with dichotomous outcomes, calculated as the number of patients whose outcome would need to change for a significant result to become non-significant. Many RCTs have compared carotid endarterectomy (CEA) and carotid artery stenting (CAS), with variable results; thus, in this systematic review, we sought to explore the FI as a possible explanation for the variability in trial results between CEA and CAS.<h4>Methods</h4>We conducted a search in MEDLINE (1946 to Apr. 22, 2024), Embase (1974 to Apr. 22, 2024), and PubMed (up to Apr. 22, 2024) for RCTs comparing CEA and CAS. We included RCTs with statistically significant results and dichotomous primary outcomes.<h4>Results</h4>Our literatCanadian journal of surgery. Journal canadien de chirurgieE90-E96https://www.ebi.ac.uk/biostudies/studies/S-EPMC12948451biostudies-literatureAssessing the fragility index of randomized controlled trials on carotid artery stenosis: a systematic review.PMC12948451Zhou ASu HMAhmed UPersad ANewton BDLiu ETilbury NKelly MOgieglo LfalseAssessing the fragility index of randomized controlled trials on carotid artery stenosis: a systematic review.<h4>Background</h4>The fragility index (FI) measures the robustness of randomized controlled trials (RCTs) with dichotomous outcomes, calculated as the number of patients whose outcome would need to change for a significant result to become non-significant. Many RCTs have compared carotid endarterectomy (CEA) and carotid artery stenting (CAS), with variable results; thus, in this systematic review, we sought to explore the FI as a possible explanation for the variability in trial results between CEA and CAS.<h4>Methods</h4>We conducted a search in MEDLINE (1946 to Apr. 22, 2024), Embase (1974 to Apr. 22, 2024), and PubMed (up to Apr. 22, 2024) for RCTs comparing CEA and CAS. We included RCTs with statistically significant results and dichotomous primary outcomes.<h4>Results</h4>Our literat2026-01-01T00:00:00Z2026 Jan-Feb2026-07-16T22:28:54.489Z2026-07-11T03:12:07.885ZS-EPMC129484514170828610.1503/cjs.008525