TY - JOUR
T1 - Carotid Angioplasty and Stenting and Embolic Protection
AU - Giordan, Enrico
AU - Lanzino, Giuseppe
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose of Review: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. Recent Findings: Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event. CAS is associated with lower incidence of periprocedural cardiac events and cranial nerve palsies. Both procedures are equally effective in preventing future ipsilateral ischemic events, and restenosis after CAS is not a major limitation. In asymptomatic patients, CAS is as safe as CEA, although modern medical therapy may be as effective as any carotid intervention. Summary: CAS is a valid alternative to CEA in selected patients with symptomatic carotid stenosis. In asymptomatic patients, the two procedures are equally safe, although medical therapy alone may be as effective.
AB - Purpose of Review: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. Recent Findings: Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event. CAS is associated with lower incidence of periprocedural cardiac events and cranial nerve palsies. Both procedures are equally effective in preventing future ipsilateral ischemic events, and restenosis after CAS is not a major limitation. In asymptomatic patients, CAS is as safe as CEA, although modern medical therapy may be as effective as any carotid intervention. Summary: CAS is a valid alternative to CEA in selected patients with symptomatic carotid stenosis. In asymptomatic patients, the two procedures are equally safe, although medical therapy alone may be as effective.
KW - Carotid embolic protection
KW - Carotid endarterectomy
KW - Carotid stenting
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U2 - 10.1007/s11886-017-0932-0
DO - 10.1007/s11886-017-0932-0
M3 - Review article
C2 - 29046977
AN - SCOPUS:85031923640
SN - 1523-3782
VL - 19
JO - Current cardiology reports
JF - Current cardiology reports
IS - 12
M1 - 120
ER -