scholarly journals Response by Weinberg et al to Letter Regarding Article, “Carotid Stent Fractures Are Not Associated With Adverse Events: Results From the ACT-1 Multicenter Randomized Trial (Carotid Angioplasty and Stenting Versus Endarterectomy in Asymptomatic Subjects Who Are at Standard Risk for Carotid Endarterectomy With Significant Extracranial Carotid Stenotic Disease)”

Circulation ◽  
2018 ◽  
Vol 137 (24) ◽  
pp. 2676-2677
Author(s):  
Ido Weinberg ◽  
Joshua A. Beckman ◽  
Yu Shu ◽  
Michael R. Jaff
Keyword(s):  
Adverse Events ◽  
Randomized Trial ◽  
Carotid Endarterectomy ◽  
Carotid Angioplasty ◽  
Carotid Stent ◽  
Multicenter Randomized Trial ◽  
Asymptomatic Subjects ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
Standard Risk

Carotid Angioplasty and Stenting versus Carotid Endarterectomy for Treatment of Asymptomatic Carotid Stenosis: A Randomized Trial in a Community Hospital

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 318-325 ◽  
Author(s):  
William H. Brooks ◽  
Rick R. McClure ◽  
Michael R. Jones ◽  
Timothy L. Coleman ◽  
Linda Breathitt
Keyword(s):  
Randomized Trial ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Hospital Charges ◽  
Carotid Angioplasty ◽  
Asymptomatic Carotid Stenosis ◽  
Asymptomatic Carotid ◽  
Procedural Complications ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Abstract OBJECTIVE Carotid endarterectomy (CEA) is effective in reducing the risk of stroke in individuals with more than 60% carotid stenosis. Carotid angioplasty and stenting (CAS) has been proffered as effective and used in treating individuals with asymptomatic carotid stenosis despite the absence of proven clinical equivalency. This randomized trial was designed to explore the hypothesis that CAS is equivalent to CEA for treating asymptomatic carotid stenosis. METHODS A total of 85 individuals presenting with asymptomatic carotid stenosis of more than 80% were selected randomly for CAS or CEA and followed up for 48 months. RESULTS Stenosis decreased to an average of 5% after CAS. The patency of the reconstructed artery remained satisfactory regardless of the technique, as determined by carotid ultrasonography. No major complications such as cerebral ischemia or death occurred. Procedural complications associated with CAS (n = 5) were hypotension and/or bradycardia; those concomitant with CEA (n = 3) were cervical nerve injury or complications related to general anesthesia (n = 4). Both procedures were well tolerated in the context of pain and discomfort. Hospital stay was similar in the two groups (mean, 1.1 versus 1.2 d). The occurrence of complications associated with CAS or CEA prolonged hospitalization by 3 days (mean, 4.0 versus 4.5 d). Return to full activity was achieved within 1 week by more than 85% of patients; all returned to their usual lifestyle by 2 weeks. Although hospital charges were slightly higher for CAS, costs were similar. CONCLUSION CAS and CEA may be equally effective and safe in treating individuals with asymptomatic carotid stenosis.

scholarly journals PS82. Carotid Endarterectomy for Treatment of In-Stent Restenosis after Carotid Angioplasty and Stenting

2011 ◽  
Vol 53 (6) ◽  
pp. 51S
Author(s):  
Boudewijn L. Reichmann ◽  
Jorinde H. van Laanen ◽  
Jean-Paul de Vries ◽  
Johanna M. Hendriks ◽  
Hence J. Verhagen ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Angioplasty ◽  
Stent Restenosis ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
In Stent Restenosis

Surgical Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S83-S91 ◽  
Author(s):  
Robert E. Harbaugh ◽  
Akshal Patel
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Carotid Artery Disease ◽  
Carotid Angioplasty ◽  
Artery Disease ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Abstract Carotid endarterectomy is a commonly performed operation to prevent stroke in patients who have asymptomatic or symptomatic internal carotid artery atherosclerotic stenosis. Carotid angioplasty and stenting has also been advocated for treatment of these patients. In this article, we address a number of questions for which a review of available data will advance our understanding of the role of carotid endarterectomy in stroke prevention. These include the following: Are carotid endarterectomy and carotid angioplasty and stenting equivalent procedures for the treatment of carotid artery disease? Which patients should be deemed at high risk for carotid endarterectomy? Should carotid endarterectomy be an urgent procedure in symptomatic patients with severe internal carotid artery stenosis? Finally, what is the role of carotid endarterectomy in asymptomatic patients? We also review the senior author's personal experience with >2000 consecutive carotid endarterectomies, with special attention to his present approach to this operation. We believe that carotid endarterectomy, in experienced hands, is a minimally invasive operation that remains the procedure of choice for most patients with carotid artery disease who will benefit from invasive treatment.

Sign in / Sign up

Export Citation Format

Share Document