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II. ENDOVASCULAR PROCEDURES. SHORT AND LONG-TERMS RESULTS THE MULTIFOCAL ATHEROSCLEROTIC PATIENT
DIAGNOSIS AND MANAGEMENT IN 2003
The Journal of Cardiovascular Surgery 2003 June;44(3):331-9
Copyright © 2009 EDIZIONI MINERVA MEDICA
lingua: Inglese
Current status in cervical carotid artery stent placement
Wholey M. H. 1, Wholey M. 2
1 Department of Cardiovascular and Interventional Radiology University of Texas Health Science Center at San Antonio, San Antonio, TX, USA 2 Pittsburgh Vascular Institute Shadyside Hospital, UPMC, Pittsburgh, PA, USA
Aim of this paper is to provide background information and the latest developments and studies pertaining to carotid artery stent placement in the treatment of carotid artery occlusive disease. A review of current literature combined with personal experience in the field of carotid stenting is presented. Endovascular stent placement for carotid artery occlusive disease is evolving from its initial controversial position to that of an alternative treatment of extracranial carotid artery disease. The high technical success (98-99%) as well as the relatively few complications makes carotid stenting a substitute for carotid endarterectomy for symptomatic patients and especially those with high medical comorbidities. With the advent of distal embolic protection, the complication rates for carotid stenting have decreased by approximately 50% to 2-4% for most major centers. Hence, with improved technology, carotid stenting is becoming an option for asymptomatic patients, especially those with high surgical risk. Early results for pa-tency and neurological follow-up have also been encouraging. When we first began performing carotid stenting in 1995, we used a mixture of peripheral and coronary techniques. As stent design, guide catheters and cerebral protection devices have become dedicated and sophisticated, the technical success, patency and complication rates have improved. Carotid stenting will increase in application in the future especially among high surgical-risk patients with symptomatic and asymptomatic carotid occlusive disease.