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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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REVIEWS  AN UPDATE ON CAROTID ARTERY STENTING


The Journal of Cardiovascular Surgery 2008 Dicembre;49(6):729-36

lingua: Inglese

The expanding indications for virtual histology intravascular ultrasound for plaque analysis prior to carotid stenting

Schiro B. J., Wholey M. H.

Department of Radiology University of Pittsburgh Medical Center Pittsburgh, PA, USA Pittsburgh Vascular Institute University of Pittsburgh Medical Center Pittsburgh, PA, USA


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Complications of carotid artery stenting (CAS), including stroke, remain relatively high when compared with carotid endarterectomy (CEA). Current selection criteria for patients undergoing CAS are based predominately on surgical risk related to other comorbidities. Little attention is given to the morphology of the atherosclerotic plaque, although studies have shown that extensive variability exists which confers certain risks for plaque vulnerability. Virtual HistologyTM intravascular ultrasound (VH IVUS) offers a unique method of assessing plaque morphology prior to CAS. Herein, the authors review the concepts of atherosclerotic plaque morphology and discuss the background of VH IVUS and illustrate its use in the carotid system. With selection of the appropriate patient and the appropriate plaque, more favorable outcomes of CAS may be achieved which will solidify its place as a frontline treatment of carotid vascular disease.

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