Carotid artery stenting: first consensus document of the ICCS-SPREAD Joint Committee.
OBJECTIVE
The prevention of stroke and the correct treatment of carotid artery stenosis represent today a major debate in cardiovascular medicine. Beside carotid endarterectomy, carotid angioplasty and stenting is becoming more widely performed for the treatment of severe carotid obstructive disease, and is now accepted as a less invasive technique that may provide an alternative for selected patients, particularly those with significant comorbidities. An Italian multidisciplinary task force, in which converged the most representative scientific societies involved in carotid treatment, was created to provide neurologists, radiologist, cardiologists, vascular surgeons, and all those involved in prevention and treatment of carotid disease with a simple, clear and updated evidence-based consensus document.


RESULTS
This First Consensus Document of the ICCS (Italian Consensus Carotid Stenting)/SPREAD group addressed the main issues related to methodology, definition of symptomatic and asymptomatic carotid stenosis, indication and procedures for carotid artery stenting, including the use of devices for preventing procedural embolic complications. Special attention was paid to credentials and competency for physicians qualifications to perform vascular angioplasty and stent placement, including training, acceptable complication rates and certification.


CONCLUSIONS
As any guideline or consensus statement, also this document is valid as long as the evidence on which it is based remains up-to-date. In such a fast-evolving field of medicine as the management of carotid stenosis, it is mandatory to stimulate a continuous and fruitful discussion among all the professionals involved in this very evolutionary field.
Cremonesi
Alberto
A
Società Italiana di Cardiologia Interventistica (Italian Society of Interventional Cardiology).
Setacci
Carlo
C
Bignamini
Angelo
A
Bolognese
Leonardo
L
Briganti
Francesco
F
Di Sciascio
Germano
G
Inzitari
Domenico
D
Lanza
Gaetano
G
Lupattelli
Luciano
L
Mangiafico
Salvatore
S
Pratesi
Carlo
C
Reimers
Bernard
B
Ricci
Stefano
S
de Donato
Gianmarco
G
Ugolotti
Ugo
U
Zaninelli
Augusto
A
Gensini
Gian Franco
GF
D002340:Carotid Artery Diseases / Q000628:therapy*; D006801:Humans; D007558:Italy; D015607:Stents