Related Experiment Video
Updated: May 13, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Carotid artery stenting update
Mehmet Cilingiroglu1, Konstantinos Marmagkiolis, Mark H Wholey
1University of Pittsburgh Medical Center Heart & Vascular Institute, PA, USA.
Insights
Carotid artery stenting is now an equally safe and effective stroke prevention method compared to traditional endarterectomy, especially for high-risk patients. This less invasive option has gained acceptance due to improved technology and patient preference.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Stroke is a leading cause of death and disability in the USA.
- Carotid artery disease accounts for approximately 25% of all strokes.
- Endarterectomy is the current standard treatment for significant carotid artery disease.
Purpose of the Study:
- To compare the safety and efficacy of carotid artery stenting (CAS) versus carotid endarterectomy (CEA).
- To evaluate CAS as an alternative stroke prevention strategy.
- To assess the role of CAS in high-risk patient populations.
Main Methods:
- Review of clinical trials including SAPPHIRE and CREST, comparing CAS and CEA.
- Analysis of procedural outcomes, including death, stroke, and myocardial infarction.
- Consideration of technological advancements and patient demand.
Main Results:
- The SAPPHIRE trial demonstrated noninferiority of CAS to CEA in high-risk patients.
- The CREST trial showed no significant difference in outcomes between CAS and CEA.
- Carotid artery stenting is now FDA-approved for high-risk patients.
Conclusions:
- Carotid artery stenting is an equally efficient and safe procedure for stroke prevention.
- Advancements in stent technology and embolic protection have improved CAS outcomes.
- Patient preference for less invasive procedures favors the adoption of CAS.
Abstract:
Stroke is the third leading cause of death and the most common cause of long-term disability in the USA. Approximately 25% of strokes are due to carotid artery disease. The mechanisms of stroke include thrombotic occlusion, thrombus embolism, atheroembolism and dissection or subintimal hematoma. Today, endarterectomy is the standard of care for management of significant carotid artery disease. The SAPPHIRE trial has proved the noninferiority of carotid artery stenting versus carotid endarterectomy in 'high-risk' patients, which led to the US FDA approval of carotid stent for high-risk patients. The CREST trial is the largest randomized trial comparing stenting versus endarterectomy and showed no significant difference in death, stroke or myocardial infarction. Over the last 15 years, the accumulation of experience, the improvement of stent platforms and embolic protection devices, and the strong demand from patients for a less invasive alternative to carotid endarterectomy has made carotid artery stenting an equally efficient and safe procedure for the prevention of stroke.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:26Atherosclerosis III: Management