Which patients benefit from carotid stenting? What recent trials show

So far, angioplasty with stenting of the carotid arteries does not seem to offer any clear advantage over traditional carotid endarterectomy for patients with symptomatic or asymptomatic stenosis. This paper reviews recent and ongoing studies of carotid revascularization, with conclusions on how the...

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Bibliographic Details
Published in:	Cleveland Clinic journal of medicine Vol. 75; no. 10; pp. 714 - 720
Main Authors:	Bain, Smark, Moheet, Asma M, Rasmussen, Peter
Format:	Journal Article
Language:	English
Published:	United States Cleveland Clinic 01-10-2008
Subjects:	Angioplasty - methods Carotid Stenosis - therapy Clinical Trials as Topic Endarterectomy, Carotid Humans Patient Selection Postoperative Complications - prevention & control Risk Stents
Online Access:	Get full text
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Summary:	So far, angioplasty with stenting of the carotid arteries does not seem to offer any clear advantage over traditional carotid endarterectomy for patients with symptomatic or asymptomatic stenosis. This paper reviews recent and ongoing studies of carotid revascularization, with conclusions on how these treatments should be used, based on what we know now. KEY POINTS In patients with asymptomatic carotid stenosis greater than 60% or symptomatic carotid stenosis greater than 50%, carotid endarterectomy has been proven to be superior to medical therapy alone. In clinical trials, carotid stenting did not appear to have a clear advantage over endarterectomy in patients at average surgical risk. Stenting may be most advantageous when used in patients with symptomatic carotid stenosis who would be at high risk of perioperative complications if they were to undergo carotid endarterectomy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0891-1150 1939-2869
DOI:	10.3949/ccjm.75.10.714