Carotid stent trials: past, present, and future.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Carotid endarterectomy is the standard surgical treatment for carotid artery disease.
• Carotid bifurcation disease poses a significant risk of stroke.
• Percutaneous interventions are increasingly explored as alternatives to open surgery.

Purpose of the Study:

• To evaluate the safety and efficacy of carotid stenting as a therapeutic option.
• To compare carotid stenting with carotid endarterectomy for carotid bifurcation disease.
• To assess the role of technological advancements in carotid stenting.

Main Methods:

• Review of contemporary data on carotid stenting procedures.
• Analysis of patient outcomes, focusing on safety and efficacy.
• Consideration of technological improvements in devices and techniques.

Main Results:

• Carotid stenting demonstrates established safety and efficacy for high-grade lesions in high-risk patients.
• Technological advancements have improved the reliability of carotid stenting.
• Ongoing clinical trials are investigating outcomes in lower-risk patient populations.

Conclusions:

• Carotid stenting is a viable alternative to carotid endarterectomy for select high-risk patients.
• Further evidence from clinical trials is required to guide treatment decisions for lower-risk patients.
• The percutaneous approach has the potential to significantly impact global carotid revascularization procedures.