scholarly journals Why carotid endarterectomy is method of choice in treatment of carotid stenosis

2008 ◽  
Vol 136 (3-4) ◽  
pp. 181-186 ◽  
Author(s):  
Djordje Radak ◽  
Lazar Davidovic
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Stent Implantation ◽  
Radical Neck Dissection ◽  
Carotid Stenting ◽  
Long Term Results ◽  
Radiation Induced ◽  
The Common ◽  
Graft Interposition

Procedures used in treatment of carotid stenosis are endarterectomy, PTA with stent implantation, resection with graft interposition and by-pass procedure. Segmental lesions are found more often and treated by the first two mentioned procedures. In case of longer lesions and extension to the greater part of the common carotid artery, the other two procedures are performed. For the past few years, the main dilemma has been whether to perform carotid endarterectomy or PTA with stent implantation. Both early and long-term results speak in favour of carotid endarterectomy, regardless of an increased number of PTA and carotid stenting. At the same time, PTA and carotid stenting are more expensive procedures. Both methods have their defined and important roles in treatment of segmental occlusive carotid lesions. Severe cardiac, pulmonary and renal conditions, which increase the risk of general anaesthesia, are not an absolute indication for PTA and stenting, since endarterectomy can be done in regional anaesthesia. Main indications for PTA with stent implantation are: surgically inaccessible lesions (at or above C2; or subclavian); radiation- induced carotid stenosis; prior ipsilateral radical neck dissection; prior carotid endarterectomy (restenosis).

Carotid Artery Stenting May Be Losing the Battle against Carotid Endarterectomy for the Management of Symptomatic Carotid Artery Stenosis, But the Jury Is Still Out

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 183-189 ◽  
Author(s):  
Kosmas I. Paraskevas ◽  
Dimitri P. Mikhailidis ◽  
Frank J. Veith
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Long Term Results ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis

Carotid artery stenting (CAS) has emerged as a potential alternative to carotid endarterectomy (CEA) for the management of carotid artery stenosis. The purpose of this article is to provide an evaluation and critical overview of the trials comparing the early and later results of CAS with CEA for symptomatic carotid stenosis. The Cochrane Controlled Trials Register, PubMed/Medline, and EMBASE databases were searched up to February 1, 2009, to identify trials comparing the long-term outcomes of CAS with CEA. The MeSH terms used were “carotid artery stenting,” “carotid endarterectomy,” “symptomatic carotid artery stenosis,” “treatment,” “clinical trial,” “randomized,” and “long-term results,” in various combinations. One single-center and three multicenter randomized studies reporting their long-term results from the comparison of CAS with CEA for symptomatic carotid stenosis were identified. All four studies independently reached the conclusion that CAS may not provide results equivalent to those of CEA for the management of symptomatic carotid stenosis. A higher incidence of recurrent stenosis and peri- and postprocedural events accounted for the inferior results reported for CAS compared with CEA. Current data from randomized studies indicate that CAS provides inferior long-term results compared with CEA for the management of symptomatic carotid artery stenosis. However, it can be argued that all of these trials were performed when both CAS equipment and CAS operators had not evolved to their current status. Given that current equipment and mature experience are required for CAS before comparing it with the current “gold standard” procedure (CEA), the results of soon-to-be reported trials (Carotid Revascularization Endarterectomy vs Stenting Trial [CREST], International Carotid Stenting Study [ICSS], or others) may alter the current impression that CAS is inferior to CEA for the treatment of symptomatic carotid stenosis.

scholarly journals Perioperative and long-term results for carotid stenting versus carotid endarterectomy

Nosotchu ◽  
2008 ◽  
Vol 30 (1) ◽  
pp. 7-13
Author(s):  
Shin-ya Fukumoto ◽  
Yoshiaki Kumon ◽  
Keiji Igase ◽  
Hideaki Watanabe ◽  
Masahiko Tagawa ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenting ◽  
Long Term Results

Long-Term Results of Carotid Endarterectomy and Carotid Stenting

2009 ◽  
pp. 101-104
Author(s):  
Hideki Ogata ◽  
Tetsuya Tsukahara ◽  
Taketo Hatano ◽  
Takuya Nakakuki ◽  
Mamoru Murakami ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenting ◽  
Long Term Results

Long-term results of phosphorylcholine-coated triplex stent implantation in porcine coronary arteries

2006 ◽  
Vol 7 (2) ◽  
pp. 106
Author(s):  
H.M. Dubé ◽  
B Cryer ◽  
A.G. Clifford ◽  
C.M. Barry ◽  
L.B. Schwartz
Keyword(s):  
Coronary Arteries ◽  
Stent Implantation ◽  
Long Term Results

Endovascular Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S92-S101 ◽  
Author(s):  
Jorge L. Eller ◽  
Travis M. Dumont ◽  
Grant C. Sorkin ◽  
Maxim Mokin ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Stenting ◽  
Historical Background ◽  
Treatment Modalities ◽  
Endovascular Management ◽  
The Past

Abstract Carotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background.

scholarly journals PERSISTENT BENEFIT FROM PACLITAXEL-ELUTING STENT IMPLANTATION IN SAPHENOUS VEIN GRAFTS: LONG-TERM RESULTS OF THE STENTING OF SAPHENOUS VEIN GRAFTS (SOS) TRIAL

2010 ◽  
Vol 55 (10) ◽  
pp. A193.E1808
Author(s):  
Christopher Lichtenwalter ◽  
James A. de Lemos ◽  
Owen Obel ◽  
Abdul-rahman Riyad Abdel-karim ◽  
Michele Roesle ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Stent Implantation ◽  
Long Term Results ◽  
Vein Grafts ◽  
Saphenous Vein Grafts

Immediate and Long-Term Results of Carotid Endarterectomy for Asymptomatic High-Grade Stenosis

1994 ◽  
Vol 8 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Thomas S. Riles ◽  
Frederick S. Fisher ◽  
Patrick J. Lamparello ◽  
Gary Giangola ◽  
Lee Gibstein ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Long Term Results ◽  
High Grade
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