Carotid artery stenting--current status and future directions.
Carotid endarterectomy has been the standard of therapy for carotid occlusive disease in stroke prevention. More recently, carotid angioplasty and stenting became an important alternative in the treatment of carotid occlusive disease. The widespread use of cerebral protection devices has substantially decreased the morbidity of the procedure. As the experience with carotid stenting increases, so does the enthusiasm for the potential of this minimally invasive carotid intervention to become the main treatment option for the high risk patients, as well as for the average asymptomatic patient. Although current available data indicate that the results regarding success and complication rates are similar between carotid stenting and endarterectomy, several prospective clinical trials are currently in progress to evaluate the efficacy of carotid artery stenting in different patient populations and definitively establish its role in the treatment of carotid disease. This paper reviews the current status of carotid stenting, including results from clinical trials, technical aspects and controversial issues and strategies to provide cerebral protection from embolization.
Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX77030, USA.
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Kougias
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Lin
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Bush
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Peden
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Zhou
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Lumsden
D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000639:trends; D016893:Carotid Stenosis / Q000175:diagnosis / Q000628:therapy*; D002986:Clinical Trials as Topic; D004691:Endarterectomy / Q000379:methods; D005544:Forecasting; D006801:Humans; D015607:Stents; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome