Endovascular treatment of extracranial carotid artery stenosis: update on carotid angioplasty and stenting.
The endovascular treatment of carotid artery stenosis has undergone substantial refinement since its introduction, and carotid artery angioplasty and stenting is now widely performed on symptomatic and asymptomatic patients. Well-designed, large randomized prospective trials showed that carotid endarterectomy provided a significant and durable benefit to selected patients with significant carotid narrowing. Many trials are currently under way comparing endovascular stenting and surgery. Two recently published trials suggest endovascular stenting is at least as good as carotid endarterectomy in terms of safety and efficacy. In the future, carotid stenting may become the standard procedure for patients with significant carotid occlusive disease and a high estimated risk of future stroke.
Cullen
Sean P
SP
Cerebrovascular Center, Interventional Neuroradiology, Brigham and Women's Hospital, Boston, MA 02114, USA. spcullen@gmail.com
Higashida
Randall T
RT
D017130:Angioplasty; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016894:Endarterectomy, Carotid; D006801:Humans; D015607:Stents; D016896:Treatment Outcome