Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/20084
Title: Carotid Artery Stenting: Current State of Evidence and Future Directions.
Authors: Lamanna, Anthony;Maingard, Julian;Barras, Christen;Kok, Hong Kuan;Handelman, Guy;Chandra, Ronil V;Thijs, Vincent N;Brooks, Duncan Mark;Asadi, Hamed
Affiliation: The University of Adelaide, Adelaide, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Department of Imaging, Monash Health, Melbourne, Australia
Interventional Neuroradiology Unit - Monash Imaging, Monash Health, Melbourne, Australia
South Australian Health and Medical Research Institute, Adelaide, Australia
Interventional Radiology Service - Department of Radiology, Austin Hospital, Melbourne, Australia
Department of Interventional Radiology - Guy's and St Thomas', NHS Foundation Trust, London, United Kingdom
Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
School of Medicine - Faculty of Health, Deakin University, Waurn Ponds, Australia
Stroke Division, The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
The University of Melbourne, Melbourne, Australia
Department of Interventional Radiology - Guy's and St Thomas', NHS Foundation Trust, London, United Kingdom
Education and Research Centre, Beaumont Hospital, Dublin, Ireland
Department of Radiology, Royal Victoria Hospital, Belfast, United Kingdom
Department of Imaging, Monash Health, Melbourne, Australia
Issue Date: 4-Jan-2019
EDate: 2019-01-04
Citation: Acta neurologica Scandinavica 2019; online first: 4 January
Abstract: Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) are common treatments for carotid artery stenosis. Several randomised controlled trials (RCTs) have compared CEA to CAS in the treatment of carotid artery stenosis. These studies have suggested that CAS is more strongly associated with periprocedural stroke, however CEA is more strongly associated with myocardial infarction. Published long-term outcomes report that CAS and CEA are similar. A reduction in complications associated with CAS has also been demonstrated over time. The symptomatic status of the patient and history of previous CEA or cervical radiotherapy are significant factors when deciding between CEA or CAS. Numerous carotid artery stents are available, varying in material, shape and design but with minimal evidence comparing stent types. The role of cerebral protection devices is unclear. Dual antiplatelet therapy is typically prescribed to prevent in-stent thrombosis, however evidence comparing periprocedural and postprocedural antiplatelet therapy is scarce, resulting in inconsistent guidelines. Several RCTs are underway that will aim to clarify some of these uncertainties. In this review, we summarise the development of varying techniques of CAS and studies comparing CAS to CEA as treatment options for carotid artery stenosis. This article is protected by copyright. All rights reserved.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20084
DOI: 10.1111/ane.13062
ORCID: 0000-0002-6614-8417
0000-0003-2475-9727
0000-0001-8958-2411
PubMed URL: 30613950
Type: Journal Article
Review
Subjects: carotid artery atherosclerosis
carotid artery stenosis
carotid artery stenting
carotid endarterectomy
stroke
stroke prevention
Appears in Collections:Journal articles

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