[Carotid stenting: an alternative to surgery?].
A stenosis of the internal carotid artery may cause 10-20% of all ischemic strokes. In symptomatic patients, carotid revascularization is indicated in the presence of a stenosis 50%. in asymptomatic patients, the indication for revascularization based on randomized trials is given at > or = 60% stenosis, as long as the estimated perioperative death or stroke risk is < 3%. In clinical practice however, asymptomatic stenoses are usually treated only if luminal narrowing exceeds 70-80%. The choice of the revascularization strategy (endarterectomy versus stenting) should be based on the surgical risk profile of the patient and on the locally available expertise. Carotid artery stenting is particularly beneficial in patients at high risk for surgery.
Roffi
M
M
Service de cardiologie, HUG, 1211 Genève 14. marco.roffi@hcuge.ch
Pereira
V
V
San
Millan D
MD
Bonvini
R F
RF
Keller
P-F
PF
Mach
F
F
Lovblad
K-O
KO
D015906:Angioplasty, Balloon, Coronary; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery / Q000628:therapy*; D016894:Endarterectomy, Carotid / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D020521:Stroke / Q000517:prevention & control*; D016896:Treatment Outcome