Endovascular Advances for Extracranial Carotid Stenosis

Endovascular Advances for Extracranial Carotid Stenosis

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Carotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background. ABBREVIATIONS: ACAS, Asymptomatic Carotid Atherosclerosis Study ACST, Asymptomatic Carotid Surgery Trial CAS, carotid artery angioplasty and stenting CAVATAS, Carotid and Vertebral Transluminal Angioplasty Study CCA, common carotid artery CEA, carotid endarterectomy CREST, Carotid Revascularization Endarterectomy vs Stenting Trial ECA, external carotid artery ECST, European Carotid Surgery Trial EVA-3S, Endarterectomy vs Stenting in Patients with Symptomatic Severe Carotid Stenosis ICA, internal carotid artery ICSS, International Carotid Stenting Study IVUS, intravascular ultrasound MI, myocardial infarction NASCET, North American Symptomatic Carotid Endarterectomy Trial SAPPHIRE, Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy SPACE, Stent supported Percutaneous Angioplasty of the Carotid artery vs Endarterectomy

Original Article: http://journals.lww.com/neurosurgery/Fulltext/2014/02001/Endovascular_Advances_for_Extracranial_Carotid.12.aspx

Julio Pereira, MD

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