Carotid stenting: should it replace endarterectomy in higher-risk patients?
Carotid artery stenting (CAS) has emerged as a useful and potentially less-invasive alternative to carotid endarterectomy (CEA) for treatment of extracranial carotid stenoses. It has been suggested that specific patient subgroups, including those with significant medical comorbidities, recurrent stenosis, anatomically inaccessible lesions, and a hostile neck, might benefit from CAS. The purpose of this report is to evaluate whether or not CAS should replace CEA in the treatment of the high-risk patient. Results from a recently published randomized clinical trial and several individual center and multicenter case analyses will be used in this review.
Hobson
Robert W
RW
CREST Administrative Center, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07107, USA. hobsonrw@umdnj.edu
D019917:Blood Vessel Prosthesis Implantation; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome