Journal article
The role of carotid angioplasty and stenting in carotid revascularization
Neurological research (New York), v 27 Suppl 1(1), pp S53-58
Oct 2005
PMID: 16197825
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The gold standard procedure for carotid revascularization has been carotid endarterectomy. Several randomized trials demonstrate that it is more efficacious than medical management in stroke prevention for both symptomatic and asymptomatic patients when performed with low surgical morbidity. However, many high-risk patients not included in these trials are now being referred for carotid revascularization. Endovascular treatment of carotid stenosis with angioplasty and stenting has become an established alternative to carotid endarterectomy (CEA) for these patients. We provide a review of the current role of carotid stent and angioplasty.
We reviewed our procedural techniques for carotid artery stenting (CAS) with an emphasis on the need for medical therapy before and after the procedure to reduce thromboembolic complications. We also retrospectively analysed our clinical outcomes and incidence of restenosis after CAS.
We evaluated 139 of 252 patients treated over a 10-year period who had a minimum of 6-month clinical and imaging (ultrasound and/or angiography) follow-up (average f/u=60 months). Our rate of major stroke, MI or death was 3%, and rate of peri-operative TIAs was 2%. Morbidity related to femoral sheath placement has been 1.5%, with one 'cold foot' resolved with heparin and one retroperitoneal hematoma requiring transfusion. Recurrent stenosis after CAS occurred in 4% of patients, predominately following radiation treatment where it was 15%.
Although CEA is the gold standard procedure to prevent stroke from carotid stenosis, CAS has an expanding role for revascualrization, particularly in high-risk patients. Several randomized prospective trials are ongoing to better define the indications for CAS versus CEA.
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Details
- Title
- The role of carotid angioplasty and stenting in carotid revascularization
- Creators
- Christopher J Koebbe - Thomas Jefferson UniversityKenneth Liebman - Thomas Jefferson UniversityErol Veznedaroglu - Jefferson Hospital for NeuroscienceRobert Rosenwasser - Jefferson Hospital for Neuroscience
- Publication Details
- Neurological research (New York), v 27 Suppl 1(1), pp S53-58
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000232604900008
- Scopus ID
- 2-s2.0-27144492272
- Other Identifier
- 991021933314804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Neurosciences