Posted by: Johnson Francis on: 27 May, 2010
A recent study by Brott GT et al for the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) Investigators published in NEJM compared carotid stenting with endarterectomy. The trial was unique in that it involved both symptomatic and asymptomatic patients with carotid stenosis and there was strict credentialing for both surgeons and interventionalists for inclusion as [...]
Posted by: Johnson Francis on: 26 Feb, 2010
Carotid angioplasty and stenting is done when there is a critical narrowing of the common carotid or internal carotid artery with recurrent symptoms. The status of intervention for an asymptomatic critical stenosis is still investigational. When done in an experienced center, the results are comparable to carotid endarterectomy, with a much lesser discomfort associated with [...]
Posted by: Johnson Francis on: 06 Dec, 2009
Proximal protection devices can be used in internal carotid artery stenting to protect the cerebral circulation. One device known as the Mo.Ma device, has been evaluated in the ARMOUR trial. The device offers proximal embolic protection based on the principle of endovascular clamping with two compliant balloons at the distal end. The balloons can be [...]
Posted by: Johnson Francis on: 06 Dec, 2009
Usually carotid stenting is done as a staged procedure to prevent hyperperfusion syndrome. Lesions at or above C2 and below the clavicle are not amenable to surgery and are taken up for carotid artery stenting. Same is true of severe comorbidities. Stenting is seldom undertaken if there is large ipsilateral neurological defect. Lesion length more [...]
