Carotid angioplasty and stenting: caveat emptor!
Carotid endarterectomy effectively reduces stroke in patients with TIA or minor stroke and a high-grade carotid stenosis. Carotid endarterectomy is also beneficial in male asymptomatic patients younger than 75 years with high-grade stenosis. Carotid stenting has not been as thoroughly evaluated as carotid endarterectomy in randomized trials. The few trials that have been performed up to now show either inferior results or suggest equivalence. Before accepting carotid stenting as a mainstream treatment for carotid stenosis, this therapy should be as critically evaluated as carotid endarterectomy was in the 1980s and 1990s.
Thijs
Vincent
V
Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
D017130:Angioplasty / Q000009:adverse effects / Q000592:standards / Q000639:trends*; D002545:Brain Ischemia / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D016893:Carotid Stenosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000592:standards / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects / Q000592:standards / Q000639:trends; D020521:Stroke / Q000503:physiopathology / Q000517:prevention & control / Q000601:surgery*; D016896:Treatment Outcome