Current status of carotid stenting

Area of Science:

• Neurology
• Vascular Surgery
• Public Health

Background:

• Stroke is a major global cause of death and disability, with significant healthcare costs.
• Internal carotid artery stenosis accounts for 10-20% of all strokes and transient ischemic attacks.
• Carotid endarterectomy (CEA) is proven effective for high-grade stenosis, especially in symptomatic patients.

Purpose of the Study:

• To review studies on carotid stenting for internal carotid artery stenosis.
• To discuss the appropriate use of percutaneous carotid revascularization.
• To emphasize optimal long-term pharmacotherapy for patients with carotid stenosis.

Main Methods:

• Review of available studies on carotid stenting procedures.
• Analysis of the impact of emboli protection devices (EPDs).
• Discussion of comparative effectiveness of CEA versus stenting.

Main Results:

• Carotid stenting, particularly with EPDs, has seen exponential growth since 2000.
• CEA remains a superior option for specific patient groups with high-grade stenosis.
• The role of percutaneous carotid revascularization is expanding.

Conclusions:

• Carotid stenting is an increasingly utilized procedure for internal carotid artery stenosis.
• Careful patient selection and the use of EPDs are crucial for safety and efficacy.
• Long-term pharmacotherapy is essential for managing patients with carotid stenosis.