Carotid artery stenting
Atherosclerotic narrowing (stenosis) of the internal carotid artery accounts for about 10–15% of ischaemic strokes. Carotid endarterectomy (CEA) reduces the risk of stroke in patients with symptomatic stenosis and – to a lesser degree – with asymptomatic carotid stenosis. Endovascular treatmen...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2012-07-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1542 |
| _version_ | 1826996717090766848 |
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| author | Leo H. Bonati Stefan T Engelter Philippe A Lyrer |
| author_facet | Leo H. Bonati Stefan T Engelter Philippe A Lyrer |
| author_sort | Leo H. Bonati |
| collection | DOAJ |
| description |
Atherosclerotic narrowing (stenosis) of the internal carotid artery accounts for about 10–15% of ischaemic strokes. Carotid endarterectomy (CEA) reduces the risk of stroke in patients with symptomatic stenosis and – to a lesser degree – with asymptomatic carotid stenosis. Endovascular treatment including balloon angioplasty and carotid artery stenting (CAS) has emerged as an alternative to CEA to treat carotid stenosis. The present review summarises the existing evidence on risks and benefits of CAS in comparison with CEA, with a focus on evidence from randomised clinical trials. Across all randomised trials, CEA was associated with a lower risk of peri-procedural stroke or death than CAS, while CAS had lower risks of myocardial infarction, cranial nerve palsy and access site haematoma. The increased stroke risk with CAS is mainly observed in elderly patients; therefore, CAS appears to be a safe option to CEA in younger patients. In the first few years following treatment, both procedures are equally effective in preventing ipsilateral recurrent strokes. Nevertheless, long-term follow-up of ongoing trials must be awaited to investigate whether a potential increase in recurrent stenosis following CAS might limit the long-term effectiveness in stroke prevention. The optimal treatment for asymptomatic carotid stenosis remains to be determined in ongoing clinical trials.
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| first_indexed | 2024-04-11T12:10:53Z |
| format | Article |
| id | doaj.art-a1cbceb19b1045abbf9f565c4a13d3eb |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:50:07Z |
| publishDate | 2012-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-a1cbceb19b1045abbf9f565c4a13d3eb2024-11-02T11:53:30ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972012-07-01142293010.4414/smw.2012.13619Carotid artery stentingLeo H. BonatiStefan T EngelterPhilippe A Lyrer Atherosclerotic narrowing (stenosis) of the internal carotid artery accounts for about 10–15% of ischaemic strokes. Carotid endarterectomy (CEA) reduces the risk of stroke in patients with symptomatic stenosis and – to a lesser degree – with asymptomatic carotid stenosis. Endovascular treatment including balloon angioplasty and carotid artery stenting (CAS) has emerged as an alternative to CEA to treat carotid stenosis. The present review summarises the existing evidence on risks and benefits of CAS in comparison with CEA, with a focus on evidence from randomised clinical trials. Across all randomised trials, CEA was associated with a lower risk of peri-procedural stroke or death than CAS, while CAS had lower risks of myocardial infarction, cranial nerve palsy and access site haematoma. The increased stroke risk with CAS is mainly observed in elderly patients; therefore, CAS appears to be a safe option to CEA in younger patients. In the first few years following treatment, both procedures are equally effective in preventing ipsilateral recurrent strokes. Nevertheless, long-term follow-up of ongoing trials must be awaited to investigate whether a potential increase in recurrent stenosis following CAS might limit the long-term effectiveness in stroke prevention. The optimal treatment for asymptomatic carotid stenosis remains to be determined in ongoing clinical trials. https://www.smw.ch/index.php/smw/article/view/1542carotid stenosisendarterectomyendovascular treatmentstentingstroke |
| spellingShingle | Leo H. Bonati Stefan T Engelter Philippe A Lyrer Carotid artery stenting Swiss Medical Weekly carotid stenosis endarterectomy endovascular treatment stenting stroke |
| title | Carotid artery stenting |
| title_full | Carotid artery stenting |
| title_fullStr | Carotid artery stenting |
| title_full_unstemmed | Carotid artery stenting |
| title_short | Carotid artery stenting |
| title_sort | carotid artery stenting |
| topic | carotid stenosis endarterectomy endovascular treatment stenting stroke |
| url | https://www.smw.ch/index.php/smw/article/view/1542 |
| work_keys_str_mv | AT leohbonati carotidarterystenting AT stefantengelter carotidarterystenting AT philippealyrer carotidarterystenting |