Chapter

Carotid artery stenting

Iqbal Malik

in Oxford Textbook of Interventional Cardiology

Published on behalf of Oxford University Press

ISBN: 9780199569083
Published online July 2011 | e-ISBN: 9780199697816 | DOI: http://dx.doi.org/10.1093/med/9780199569083.003.042

Series: Oxford Textbooks

Carotid artery stenting

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Stroke is the third leading cause of death in the developed world. Internal carotid artery (ICA) stenosis is a major correctable cause of ischaemic stroke, the risk being related to the degree of stenosis and the presence of recent symptoms. Carotid endarterectomy (CEA) has become the preferred method of treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis, supplanting medical therapy alone. In coronary disease, the increasing use of percutaneous coronary intervention (PCI) has reduced the need for coronary artery bypass surgery (CABG). Unlike coronary stenting, where immediate relief of anginal symptoms can justify the procedure, carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. For significant (greater than 50% angiographic) ICA stenosis, carotid artery stenting (CAS) is a reasonable alternative to CEA, but its true place is as yet undecided, and awaits the conclusion of several ongoing randomized trials.

Chapter.  14548 words.  Illustrated.

Subjects: Radiology ; Cardiovascular Medicine

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