Angioplastia y stenting de la estenosis carotídea. ¿Alternativa terapéutica o posibilidad técnica?

Translated title of the contribution: Angioplasty and stenting of carotid stenosis. Therapeutic alternative or technical possibility?

A. Forteza, A. Rabinstein

Research output: Contribution to journalReview article

6 Scopus citations

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.

Original languageSpanish
Pages (from-to)270-275
Number of pages6
JournalRevista de Neurologia
Volume32
Issue number3
StatePublished - Feb 1 2001

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Keywords

  • Angioplasty
  • Carotid endarterectomy
  • Carotid stenosis
  • Complications
  • Indications
  • Stenting
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology

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