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Current Cardiology Reports
Published in: Current Cardiology Reports 12/2017

01-12-2017 | Stroke (JF Meschia, Section Editor)

Carotid Angioplasty and Stenting and Embolic Protection

Authors: Enrico Giordan, Giuseppe Lanzino

Published in: Current Cardiology Reports | Issue 12/2017

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Abstract

Purpose of Review

We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues.

Recent Findings

Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event. CAS is associated with lower incidence of periprocedural cardiac events and cranial nerve palsies. Both procedures are equally effective in preventing future ipsilateral ischemic events, and restenosis after CAS is not a major limitation. In asymptomatic patients, CAS is as safe as CEA, although modern medical therapy may be as effective as any carotid intervention.

Summary

CAS is a valid alternative to CEA in selected patients with symptomatic carotid stenosis. In asymptomatic patients, the two procedures are equally safe, although medical therapy alone may be as effective.
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Metadata
Title
Carotid Angioplasty and Stenting and Embolic Protection
Authors
Enrico Giordan
Giuseppe Lanzino
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 12/2017
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-017-0932-0

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