TITLE

Treatment of Carotid Artery Stenosis: Medical Therapy, Surgery, or Stenting?

AUTHOR(S)
Lanzino, Giuseppe; Rabinstein, Alejandro A.; Brown Jr., Robert D.
PUB. DATE
April 2009
SOURCE
Mayo Clinic Proceedings;Apr2009, Vol. 84 Issue 4, p362
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
With the aging of the general population and the availability of noninvasive imaging studies, carotid artery stenosis is a disease commonly seen in general medical practice. Differentiation between symptomatic and asymptomatic disease is critical to the treatment course because the natural history differs markedly between them. Antiplatelet therapy and aggressive treatment of vascular risk factors are the mainstays of medical therapy. Class I evidence shows that carotid endarterectomy (CEA) is effective in preventing ipsilateral ischemic events in patients with symptomatic moderate- and high-grade stenosis. The procedure is also effective in selected patients with asymptomatic stenosis, but the benefit is marginal. In the past decade, carotid angioplasty and stenting has been proposed as a valid alternative to CEA. Currently, it is unclear whether carotid angioplasty and stenting is as safe as CEA In patients with carotid artery stenosis who need invasive treatment. Large clinical trials are under way to answer this question.
ACCESSION #
37356608

 

Related Articles

  • Stent-protected angioplasty versus carotid endarterectomy in patients with carotid artery stenosis: meta-analysis of randomized trial data. Wiesmann, Martin; Schöpf, Veronika; Jansen, Olav; Brückmann, Hartmut // European Radiology;Dec2008, Vol. 18 Issue 12, p2956 

    Stent-protected angioplasty of carotid artery stenosis may be an alternative to surgical endarterectomy. Results published so far are indecisive, with evidence both in favour of and against this procedure. After the recent publication of two large European multicentre trials (SPACE and EVA-3S)...

  • Management of Carotid Artery Disease. Jackson, Carol Mackenzie // Clinician Reviews;Jan2010, Vol. 20 Issue 1, p21 

    The author offers recommendations for examining asymptomatic individuals and for carotid artery disease (CAD) treatment options using carotid endarterectomy or carotid angioplasty with stenting. He explains the scope and screening of carotid artery stenosis (CAS). He discusses the role of...

  • NASCET, ECST, ACAS -- Who Should Undergo Operation? Lam, Everett Y.; Moneta, Gregory L. // Vascular Surgery;Jan/Feb2000, Vol. 34 Issue 1, p1 

    Discusses the effectiveness of surgical procedure carotid endarterectomy. Improved neurological outcome after carotid arterectomy for patients with symptomatic and asymptomatic carotid stenosis; Information on antiplatelet agents, carotid angioplasty and stent placement used to alter the...

  • Carotid artery surgery: back to the future. Bosiers, Marc; Kleinsorge, Gustavo Henrique Dumont; Deloose, Koen; Navarro, Túlio Pinho // Jornal Vascular Brasileiro;Mar2011, Vol. 10 Issue 1, p44 

    In this study we performed 548 carotid revascularizations between 2006 and 2008 at the Department of Vascular Surgery of the A.Z. Sint-Blasius, Dendermonde, Belgium - a high-volume experienced center for carotid artery stenting (CAS). In 2006, our 30-day complication rates were 3.21 and 1.51%...

  • Treatment of Recurrent Carotid Stenosis: Angioplasty with Stenting versus Reoperative Carotid Surgery. Lepore, Michael R.; Jordan Jr, William D.; Fisher, Winfield S.; Voellinger, David C.; Redden, David; McDowell, Holt A. // Vascular Surgery;Nov/Dec1998, Vol. 32 Issue 6, p523 

    Surgical treatment of recurrent carotid stenosis (RCS) requires additional decision making as compared with the treatment of primary carotid disease. The thromboembolic risk of the lesion may vary according to the time interval from the original carotid endarterectomy to the recurrence of...

  • Carotid Artery Stenting With Filter Protection in High-Risk Patients Showing Severe Electroencephalographic Alterations During Carotid Endarterectomy. Gandini, Roberto; Spinelli, Alessio; Fabiano, Sebastiano; Colangelo, Vittorio; Marciani, Maria Grazia; Romigi, Andrea; Simonetti, Giovanni // Journal of Endovascular Therapy (Allen Press Publishing Services;Aug2006, Vol. 13 Issue 4, p451 

    Purpose: To describe the results and efficacy of stent treatment in patients with carotid stenosis who had aborted carotid endarterectomy procedures due to the appearance of severe electroencephalographic (EEG) alterations. Methods: A retrospective study was conducted of 18 patients (11 men;...

  • Carotid Stenting vs. Endarterectomy for Symptomatic Stenosis: Endarterectomy Remains the Gold Standard. Fink, Matthew E. // Neurology Alert;Dec2009, Vol. 28 Issue 4, p25 

    CAROTID ARTERY ANGIOPLASTY AND STENTING (CAS) BURST UPON the scene about 15 years ago and quickly became popular with endovascular specialists in cardiology, vascular surgery, neurosurgery, interventional radiology, interventional neuroradiology, and neurology. As so often happens with a new...

  • Carotid Artery Angioplasty and Stenting: Introduction of a New Technique Into an Established Vascular Surgery Center. Albacker, Turki B.; Nouh, Thamer A.; Alabbad, Saleh I.; Corriveau, Marc M.; MacKenzie, Kent S.; Obrand, Daniel I.; Steinmetz, Oren K.; Abraham, Cherrie Z. // Vascular & Endovascular Surgery;Apr/May2009, Vol. 43 Issue 2, p144 

    Background: The aim of this study was to review our initial experience with the introduction of carotid artery angioplasty and stenting as a treatment for carotid stenosis in high-risk patients and compare clinical outcomes to carotid endarterectomy patients treated over the same time period at...

  • Study: CAS as effective as CAE 'medium term.'.  // Cardiovascular Devices & Drugs;Oct2008, Vol. 14 Issue 10, p20 

    The article discusses research being done on the similar effectiveness of carotic angioplasty with stenting (CAS) and carotid artery endarterectomy (CAE) in preventing ipsilateral stroke in patients with stenosis of the carotid artery. It references a study published in the September 6, 2008...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics