Intermediate outcome after carotid stenting: what should we expect?

Area of Science:

• Vascular Surgery
• Neurology
• Interventional Cardiology

Background:

• Extracranial carotid artery atherosclerosis is a major cause of stroke, a leading cause of death and disability.
• Carotid artery disease accounts for approximately 35% of all ischemic cerebral infarctions, leading to an estimated 150,000 strokes annually in the US.
• Surgical endarterectomy is a proven treatment for severe carotid stenosis in symptomatic and asymptomatic patients.

Purpose of the Study:

• To review the expanding field of carotid artery angioplasty and stenting (CAS).
• To explore newer endovascular revascularization methods for extracranial carotid artery disease.
• To discuss upcoming clinical trials comparing CAS with surgical endarterectomy.

Main Methods:

• Review of current literature on carotid artery angioplasty and stenting.
• Analysis of technological advances in endovascular treatments applied to the extracranial circulation.
• Examination of prospective randomized clinical trials comparing surgical endarterectomy and CAS.

Main Results:

• Carotid endarterectomy has been a heavily scrutinized and effective surgical option for decades.
• Endovascular techniques, including angioplasty and stenting, are increasingly applied to extracranial carotid disease.
• Prospective randomized trials are underway to compare surgical endarterectomy with CAS.

Conclusions:

• Carotid artery angioplasty and stenting represent a rapidly expanding field in treating carotid stenosis.
• The comparison between surgical endarterectomy and CAS will be crucial for future treatment guidelines.
• Further research is needed to establish the optimal revascularization strategy for carotid artery disease.