[Interventional Therapy for Extracranial Carotid Stenosis]

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Extracranial internal carotid artery (ICA) stenosis is treated with surgical endarterectomy (CEA) or endovascular stent implantation (CAS).
• Revascularization is recommended for symptomatic ICA stenosis (50-99%) and selected asymptomatic cases (60-99%).
• Optimal medical therapy is the primary treatment for asymptomatic stenosis, with revascularization considered based on individual risk assessment.

Purpose of the Study:

• To review current guidelines and treatment considerations for extracranial internal carotid artery stenosis.
• To highlight the importance of patient selection and technological advancements in endovascular revascularization.
• To emphasize the role of interdisciplinary decision-making in choosing between CEA and CAS.

Main Methods:

• Review of current guidelines and relevant studies on carotid artery stenosis treatment.
• Analysis of factors influencing the choice between surgical and endovascular revascularization.
• Discussion of technological advancements in carotid artery stenting (CAS).

Main Results:

• Both CEA and CAS are established treatments, with specific indications based on stenosis severity and symptoms.
• Endovascular therapy (CAS) is associated with a higher incidence of minor strokes and transient ischemic attacks (TIAs).
• Patient selection and embolic protection are critical for safe and effective CAS.
• Innovative stent designs improve plaque coverage and reduce peri-procedural stroke rates.

Conclusions:

• The choice between CEA and CAS requires an interdisciplinary approach, considering patient-specific and anatomical factors.
• Technological advancements in CAS enhance safety and reduce complications.
• Careful patient selection and procedural techniques are paramount for successful carotid revascularization.