World neurosurgery · 2011
Carotid artery stenting for primary and secondary stroke prevention.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Siddiqui Adnan H, Natarajan Sabareesh K, Hopkins L Nelson, Levy Elad I
Аннотация
BACKGROUND: Carotid artery disease is a major cause of the disability and mortality associated with strokes. Ischemic stroke remains the major cause of adult disability and third-leading cause of adult mortality, and carotid revascularization currently remains the principal surgical tool in the prophylaxis of this disease.
METHODS: The literature representing the current body of evidence for carotid revascularization and the authors' current practices in the management of this disease are summarized in this review.
RESULTS: We provide an evidence-based narration of the development and current status of carotid artery stenting (CAS) by reviewing 1) the evidence for carotid revascularization from early carotid endarterectomy (CEA) trials; 2) the randomized trials comparing CEA and CAS, with a special emphasis on the recently published results of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), which have been a "game-changer," tipping the balance towards accepting CAS as a safe, equally effective, and durable alternative to CEA for all patients requiring carotid revascularization; and 3) the technical advances in CAS after enrollment of patients in the CREST.
CONCLUSIONS: CAS and CEA are complementary procedures. Judicious selection of the procedure is made on a case-by-case basis.
METHODS: The literature representing the current body of evidence for carotid revascularization and the authors' current practices in the management of this disease are summarized in this review.
RESULTS: We provide an evidence-based narration of the development and current status of carotid artery stenting (CAS) by reviewing 1) the evidence for carotid revascularization from early carotid endarterectomy (CEA) trials; 2) the randomized trials comparing CEA and CAS, with a special emphasis on the recently published results of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), which have been a "game-changer," tipping the balance towards accepting CAS as a safe, equally effective, and durable alternative to CEA for all patients requiring carotid revascularization; and 3) the technical advances in CAS after enrollment of patients in the CREST.
CONCLUSIONS: CAS and CEA are complementary procedures. Judicious selection of the procedure is made on a case-by-case basis.
Предметные рубрики MeSH
Age FactorsCanadaCarotid ArteriesCarotid StenosisCerebral RevascularizationClinical Trials as TopicEquipment DesignEuropeEvidence-Based MedicineGuidelines as TopicHumansPrimary PreventionQuality of LifeRandomized Controlled Trials as TopicRegistriesRiskSecondary PreventionSex FactorsStentsStrokeUnited StatesUnited States Food and Drug Administration