Chapter

Cerebrovascular Disease and Carotid Artery Stenting

Peter C. Spittell and David R. Holmes

in Mayo Clinic Cardiology

Fourth edition

Published on behalf of © Mayo Foundation for Medical Education and Research

Published in print November 2012 | ISBN: 9780199915712
Published online May 2013 | e-ISBN: 9780199322824 | DOI: http://dx.doi.org/10.1093/med/9780199915712.003.0907

Series: Mayo Clinic Scientific Press

Cerebrovascular Disease and Carotid Artery Stenting

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Carotid artery disease is common in patients with atherosclerosis in other vascular beds (ie, coronary and peripheral arteries) and has a wide spectrum of clinical presentations (asymptomatic carotid bruit, TIA, or stroke). Given the dire consequences of stroke and the fact that stroke may not be preceded by warning symptoms or signs such as TIA, there has been great interest in predicting and identifying patients at risk. Identification of carotid artery stenosis has been an important component of this process. Carotid endarterectomy is superior to medical therapy for patients with symptomatic carotid artery disease and a high-grade stenosis, including carotid territory or retinal TIAs or nondisabling stroke with an ipsilateral high-grade carotid artery stenosis. The increased morbidity and mortality associated with carotid endarterectomy in high-risk patients formed the rationale for the application of carotid artery stenting. Pertinent clinical trials are also reviewed.

Chapter.  3870 words.  Illustrated.

Subjects: Cardiovascular Medicine

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