Semin intervent Radiol 2002; 19(4): 313-320
DOI: 10.1055/s-2002-36746
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Endarterectomy, Carotid Stenting, and Stroke Prevention

Steven J. Willing1 , Nilesh H. Patel2
  • 1Interventional Neuroradiology, Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana and
  • 2Section of Vascular and Interventional Radiology, Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana
Further Information

Publication History

Publication Date:
21 January 2003 (online)

ABSTRACT

Stroke is the third leading cause of death in North America and the leading cause of permanent disability. The most common cause is carotid atherosclerosis leading to cerebral ischemia or thromboembolism. Carotid endarterectomy has been shown to benefit a select group of patients by reducing the long-term stroke risk. Carotid angioplasty and stenting have recently emerged as a controversial alternative to endarterectomy. In this article, we explore the rationale behind the treatment of carotid stenosis, critically examine the evidence in support of endarterectomy, and review the current status of carotid angioplasty and stenting.

REFERENCES

  • 1 Barnett H J, Taylor D W, Eliasziw M. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.  N Engl J Med . 1998;  339 1415-1425
  • 2 Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.  N Engl J Med . 1991;  325 445-453
  • 3 Ferguson G G, Eliasziw M, Barr H W. The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients.  Stroke . 1999;  30 1751-1758
  • 4 Carotid surgery versus medical therapy in asymptomatic carotid stenosis. The CASANOVA Study Group.  Stroke . 1991;  22 1229-1235
  • 5 Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis. Mayo Asymptomatic Carotid Endarterectomy Study Group.  Mayo Clin Proc . 1992;  67 513-518
  • 6 Hobson 2nd W R, Weiss D G, Fields W S. Efficacy of carotid endarterectomy for asymptomatic carotid stenosis. The Veterans Affairs Cooperative Study Group.  N Engl J Med . 1993;  328 221-227
  • 7 Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study.  JAMA . 1995;  273 1421-1428
  • 8 Perry J R, Szalai J P, Norris J W. Consensus against both endarterectomy and routine screening for asymptomatic carotid artery stenosis. Canadian Stroke Consortium.  Arch Neurol . 1997;  54 25-28
  • 9 Risk of stroke in the distribution of an asymptomatic carotid artery. The European Carotid Surgery Trialists Collaborative Group.  Lancet . 1995;  345 209-212
  • 10 Muller M, Reiche W, Langenscheidt P, Hassfeld J, Hagen T. Ischemia after carotid endarterectomy: comparison between transcranial Doppler sonography and diffusion-weighted MR imaging.  AJNR Am J Neuroradiol . 2000;  21 47-54
  • 11 Barth A, Remonda L, Lovblad K O, Schroth G, Seiler R W. Silent cerebral ischemia detected by diffusion-weighted MRI after carotid endarterectomy.  Stroke . 2000;  31 1824-1828
  • 12 Wennberg D E, Lucas F L, Birkmeyer J D, Bredenberg C E, Fisher E S. Variation in carotid endarterectomy mortality in the Medicare population: trial hospitals, volume, and patient characteristics.  JAMA . 1998;  279 1278-1281
  • 13 Hsia D C, Moscoe L M, Krushat W M. Epidemiology of carotid endarterectomy among Medicare beneficiaries: 1985-1996 update.  Stroke . 1998;  29 346-350
  • 14 Karp H R, Flanders W D, Shipp C C, Taylor B, Martin D. Carotid endarterectomy among Medicare beneficiaries: a statewide evaluation of appropriateness and outcome.  Stroke . 1998;  29 46-52
  • 15 Cebul R D, Snow R J, Pine R, Hertzer N R, Norris D G. Indications, outcomes, and provider volumes for carotid endarterectomy.  JAMA . 1998;  279 1282-1287
  • 16 Goldstein L B, Samsa G P, Matchar D B, Oddone E Z. Multicenter review of preoperative risk factors for endarterectomy for asymptomatic carotid artery stenosis.  Stroke . 1998;  29 750-753
  • 17 Ruby S T, Robinson D, Lynch J T, Mark H. Outcome analysis of carotid endarterectomy in Connecticut: the impact of volume and specialty.  Ann Vasc Surg . 1996;  10 22-26
  • 18 Kresowik T F, Bratzler D, Karp H R. Multistate utilization, processes, and outcomes of carotid endarterectomy.  J Vasc Surg . 2001;  33 227-235
  • 19 Kresowik T F, Hemann R A, Grund S L. Improving the outcomes of carotid endarterectomy: results of a statewide quality improvement project.  J Vasc Surg . 2000;  31 918-926
  • 20 Kerber C W, Cromwell L D, Loehden O L. Catheter dilatation of proximal carotid stenosis during distal bifurcation endarterectomy.  AJNR Am J Neuroradiol . 1980;  1 348-349
  • 21 Kachel R. Results of balloon angioplasty in the carotid arteries.  J Endovasc Surg . 1996;  3 22-30
  • 22 Yadav J S, Roubin G S, Iyer S. Elective stenting of the extracranial carotid arteries.  Circulation . 1997;  95 376-381
  • 23 Diethrich E B, Ndiaye M, Reid D B. Stenting in the carotid artery: initial experience in 110 patients.  J Endovasc Surg . 1996;  3 42-62
  • 24 Jordan Jr D W, Voellinger D C, Fisher W S, Redden D, McDowell H A. A comparison of carotid angioplasty with stenting versus endarterectomy with regional anesthesia.  J Vasc Surg . 1998;  28 397-403
  • 25 Golledge J, Mitchell A, Greenhalgh R M, Davies A H. Systematic comparison of the early outcome of angioplasty and endarterectomy for symptomatic carotid artery disease.  Stroke . 2000;  31 1439-1443
  • 26 Roubin G S, New G, Iyer S S. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis.  Circulation . 2001;  103 532-537
  • 27 Vitek J J, Roubin G S, Al-Mubarek N, New G, Iyer S S. Carotid artery stenting: technical considerations.  AJNR Am J Neuroradiol . 2000;  21 1736-1743
  • 28 Reimers B, Corvaja N, Moshiri S. Cerebral protection with filter devices during carotid artery stenting.  Circulation . 2001;  104 12-15
  • 29 Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial.  Lancet . 2001;  357 1729-1737
  • 30 Hobson 2nd W R. Carotid angioplasty-stent: clinical experience and role for clinical trials.  J Vasc Surg . 2001;  33 S117-S123
  • 31 Rothwell P M, Warlow C P. Prediction of benefit from carotid endarterectomy in individual patients: a risk-modelling study. European Carotid Surgery Trialists' Collaborative Group.  Lancet . 1999;  353 2105-2110
  • 32 Henderson R D, Eliasziw M, Fox A J, Rothwell P M, Barnett H J. Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.  Stroke . 2000;  31 128-132
  • 33 Biller J, Feinberg W M, Castaldo J E. Guidelines for carotid endarterectomy: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association.  Stroke . 1998;  29 554-562
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