J Clin Outcomes Manage
What is the role of carotid stenting in patients with carotid artery disease?
Meier P, Gurm H
Abstract: Objective: To discuss treatment with carotid stenting in patients with carotid artery disease. Methods: Historical overview and evidence review. Results: Carotid stenosis is responsible for approximately 1 in 5 strokes. To decrease the risk of stroke and stroke-related death in patients with carotid stenosis, the main treatment modality has been carotid endarterectomy (CEA). Several randomized trials have established the benefit of CEA over medical management in symptomatic and asymptomatic patients in the prevention of stroke and death. Over the past years, carotid artery stenting (CAS) has emerged as a less invasive alternative, with a number of studies indicating that CAS is feasible, safe, and effective. However, results from various randomized controlled trials comparing CAS to CEA have been ambiguous, mainly due to the heterogeneous nature of these trials. The periprocedural risk for CAS is somewhat higher, while over the longer term, both treatments show rather equivalent results. Conclusion: The steady improvement of CAS techniques will likely further improve outcomes of CAS, and the procedure is likely to emerge as a viable revascularization strategy in all patients with carotid disease.
Clinical Review Article
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