Use of stents to treat extracranial cerebrovascular disease.
Stent-assisted carotid angioplasty (CAS) is increasingly utilized for hemodynamically significant stenoses of the extracranial carotid artery. Carotid endarterectomy (CEA) is still considered the gold standard in the management of symptomatic hemodynamically significant carotid stenoses. However, endovascular device technology is rapidly evolving and the recent introduction of embolic filtration devices (EFD) proved to reduce periprocedural stroke rates in CAS considerably. Several randomized multicenter trials are currently recruiting patients to compare CAS with EFD to carotid endarterectomy in different cohorts, such as patients at high surgical risk for CEA and those with asymptomatic stenosis. The review presents current developments in CAS.
Meyers
Philip M
PM
Department of Radiology and Neurological Surgery, Columbia University, and Neuroendovascular Service, Neurological Institute of New York and New York Presbyterian Hospitals, New York, New York 10032, USA. pmm2002@columbia.edu
Schumacher
H Christian
HC
Higashida
Randall T
RT
Leary
Megan C
MC
Caplan
Louis R
LR
D017130:Angioplasty; D016893:Carotid Stenosis / Q000628:therapy*; D004691:Endarterectomy; D006801:Humans; D020766:Intracranial Embolism / Q000517:prevention & control; D015607:Stents; D014715:Vertebrobasilar Insufficiency / Q000628:therapy