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- W58111871 abstract "Affecting over half a million people per year, stroke is the third leading cause of death in the United States. Approximately 30% of strokes are caused by carotid occlusive disease.1 The traditional methods of treating carotid stenosis have included medical or surgical therapy. Patients with symptomatic moderate or severe cervical carotid artery stenosis have been treated with carotid endarterectomy (CEA). Medical therapy with aspirin and more recently with clopidogrel (Plavix) has been reserved for mild-to-moderate (asymptomatic) carotid stenosis or noncervical carotid stenosis.First performed nearly 26 years ago, carotid artery stenting (CAS) has, until recently, been only a footnote in the treatment of carotid artery disease, because it was performed at only a few centers for a few select indications2 (Fig. 1).Fig. 1 The RX AccuLink Carotid Stent (Top: 8 mm × 4 cm; Bottom: 8 mm × 6 mm × 4 cm). The advantage of nitinol is its continued expansion when in association with the higher temperature of blood. (Courtesy of Guidant, Inc.; Santa ...Coupled with the recent development and improvement of distal embolic protection devices (EPD), CAS has become a viable option in the treatment of carotid artery occlusive disease (Fig. 2). Carotid endarterectomy, until 1997, was the only therapy for carotid revascularization. However, in high-risk patients, CAS may actually offer similar or better results when all of the data, trials, and results are reviewed. When evaluating CAS versus CEA and “the controversy,” it is important to look at the history of CEA and CAS, the landmark trials, and future directions.Fig. 2 RX Accunet Embolic Protection System (Guidant, Inc.; Santa Clara, Calif). This membrane has pores of only 150 microns and thus filters any debris that is liberated during the stenting procedure." @default.
- W58111871 created "2016-06-24" @default.
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- W58111871 date "2005-01-01" @default.
- W58111871 modified "2023-09-26" @default.
- W58111871 title "Carotid artery stenosis: an endovascular specialist's perspective." @default.
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