Abstract
Objective. Review the current knowledge on the use of angioplasty and stenting (A/S) for the treatment of carotid stenosis with emphasis on proposed indications. Development. The standard treatment for carotid stenosis is carotid endarterectomy (CE). However, excessive surgical risk and/or technical difficulty occasionally impose limitations on the surgical approach. Therefore, the option of percutaneous treatment with A/S becomes an appealing alternative. A/S techniques are constantly improved but there is very little prospective data supporting its value at present. The reported complication rates appear comparable to those of CE. Indications for A/S of the carotid artery are not fully delineated yet. We believe that adequate candidates for carotid A/S must have symptomatic high-degree carotid stenosis and at least one of the following situations: unstable coronary disease, severe systemic disease, surgically inaccessible carotid lesion (including some cases of carotid stenosis secondary to neck radiation), contralateral carotid occlusion, or recurrent stenosis after prior CE. Conclusions. A/S represents a promising alternative to CE in the treatment of carotid stenosis. However, in the absence of prospective comparative trials, A/S should be currently reserved exclusively for those patients in whom surgery is prohibited by very high surgical risk or technical inaccessibility. A/S of the carotid artery should only be performed by operators with ample expertise in the field.
Translated title of the contribution | Angioplasty and stenting of carotid stenosis. Therapeutic alternative or technical possibility? |
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Original language | Spanish |
Pages (from-to) | 270-275 |
Number of pages | 6 |
Journal | Revista de Neurologia |
Volume | 32 |
Issue number | 3 |
DOIs | |
State | Published - Feb 1 2001 |
Keywords
- Angioplasty
- Carotid endarterectomy
- Carotid stenosis
- Complications
- Indications
- Stenting
- Treatment
ASJC Scopus subject areas
- Clinical Neurology