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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
ADVANCES IN CAROTID ARTERY STENTING
Stabile E., Biamino G., Sorropago G., Rubino P.
Laboratory of Invasive Cardiology,, Clinica Montevergine, Mercogliano, Avellino, Italy
Carotid artery stenting (CAS) is considered to be an acceptable alternative to carotid endarterectomy (CEA), particularly in patients at increased risk for CEA. The safety of CAS has improved significantly over the past decade. Adjunctive use of embolic protection devices (EPDs), is thought to be partially responsible for the improved outcomes. Among these, proximal EPDs are based on the surgical principle of stopping or reversing flow by clamping the carotid arteries, much in the same way carotid endarterectomy accomplishes neuroprotection. This is achieved through external and common carotid clamping. A recent meta-analysis demonstrates that the use of proximal EPDs for neuroprotection in patients undergoing CAS is associated with a very low incidence of any strokes and composite MACCE at 30 days. This study also demonstrates that the excellent outcomes achieved using proximal EPDs are independent of patient gender, symptomatic status, and other baseline clinical characteristics including the presence of a contralateral carotid occlusion.