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Use of stents to treat extracranial cerebrovascular disease

Philip M Meyers1, H Christian Schumacher, Randall T Higashida

  • 1Department of Radiology and Neurological Surgery, Columbia University, and Neuroendovascular Service, Neurological Institute of New York and New York Presbyterian Hospitals, New York, New York 10032, USA. pmm2002@columbia.edu

Annual Review of Medicine
|January 18, 2006
PubMed

Insights

Stent-assisted carotid angioplasty with embolic filtration devices significantly reduces stroke risk compared to traditional methods. Ongoing trials compare this advanced technique to carotid endarterectomy for various patient groups.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Carotid endarterectomy (CEA) is the standard for significant carotid artery stenosis.
  • Stent-assisted carotid angioplasty (CAS) is gaining traction for extracranial carotid artery disease.

Purpose of the Study:

  • To review current advancements in CAS.
  • To highlight the impact of embolic filtration devices (EFD) on CAS outcomes.

Main Methods:

  • Review of current literature and clinical developments in CAS.
  • Discussion of randomized multicenter trials comparing CAS with EFD to CEA.

Main Results:

  • Embolic filtration devices (EFD) have substantially decreased periprocedural stroke rates in CAS.
  • Ongoing trials are evaluating CAS with EFD against CEA in high-risk and asymptomatic patients.

Conclusions:

  • CAS with EFD represents a significant evolution in treating carotid artery stenosis.
  • Further research through ongoing trials will clarify the role of CAS with EFD in comparison to CEA.

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