Carotid arterial stenting
Updates to Article Attributes
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Carotid arterial stenting (CAS) is a minimally invasive endovascular interventional procedure that can potentially offer the same advantage as surgery (carotid endarterectomy).
Indications
Indications of carotid stenting are evolving with endarterectomy trials that evaluated the carotid stenosis cutoff values for treatment:
- symptomatic patients with at least 70% stenosis
(NASCET Trial(NASCET trial) - asymptomatic patients with greater than 60% stenosis (ACAS study)
- symptomatic patients with stenosis of at least 50-69% stenosis
.
Contraindications
- complete carotid occlusion
- major disabling stroke on the ipsilateral side/disabling dementia
- intracranial tumour/haemorrhage
- thick
Calcificationcalcification at the site of carotid stenosis
Complications
- preprocedural cerebrovascular accident
- reported incidence is at ~8% 3
- recurrent carotid arterial stenosis
- reported incidence is at ~6% at 1 year 4
Alternative interventional options
History and etymology
The first percutaneous transluminal carotid angioplasty (PTA) was performed by Charles Kerber in 1980 5.
-<p><strong>Carotid arterial stenting (CAS)</strong> is a minimally invasive endovascular interventional procedure.</p><h4>Indications</h4><p>Indications of carotid stenting are evolving with endarterectomy trials:</p><ol>-<li>symptomatic patients with at least 70% stenosis (NASCET Trial)</li>-<li>asymptomatic patients with greater than 60% stenosis </li>-<li>symptomatic patients with stenosis of at least 50-69% stenosis.</li>-</ol><h4>Contraindications</h4><ol>- +<p><strong>Carotid arterial stenting (CAS)</strong> is a minimally invasive endovascular interventional procedure that can potentially offer the same advantage as surgery (<a href="/articles/carotid-endarterectomy">carotid endarterectomy</a>).</p><h4>Indications</h4><p>Indications of carotid stenting are evolving with endarterectomy trials that evaluated the <a href="/articles/carotid-artery-stenosis">carotid stenosis cutoff values for treatment</a>:</p><ul>
- +<li>symptomatic patients with at least 70% stenosis (<a title="North American Symptomatic Carotid Endarterectomy Trial (NASCET)" href="/articles/carotid-artery-stenosis">NASCET</a> trial)</li>
- +<li>asymptomatic patients with greater than 60% stenosis (ACAS study) </li>
- +<li>symptomatic patients with stenosis of at least 50-69% stenosis</li>
- +</ul><h4>Contraindications</h4><ul>
-<li>thick Calcification at the site of carotid stenosis</li>-</ol><h4>Complications</h4><ul>- +<li>thick calcification at the site of carotid stenosis</li>
- +</ul><h4>Complications</h4><ul>
-</ul><h4>Alternative interventional options</h4><ul><li><a href="/articles/carotid-endarterectomy">carotid endarterectomy</a></li></ul><p> </p>- +</ul><h4>Alternative interventional options</h4><ul><li><a href="/articles/carotid-endarterectomy">carotid endarterectomy</a></li></ul><h4>History and etymology</h4><p>The first percutaneous transluminal carotid angioplasty (PTA) was performed by <strong>Charles Kerber</strong> in 1980 <sup>5</sup>. </p><p> </p>
References changed:
- 5. Liistro F, Di Mario C. Carotid artery stenting. Heart. 2003;89 (8): 944-8. <a href="http://dx.doi.org/10.1136/heart.89.8.944">doi:10.1136/heart.89.8.944</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767778">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/12860884">Pubmed citation</a><span class="auto"></span>
Images Changes:
Image 1 DSA (angiography) (Left ICA) ( update )
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Case 1: pre stent angiogram
Image 2 DSA (angiography) (Post carotid stenting) ( update )
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Case 1: post stent angiogram
Image 3 DSA (angiography) (Common carotid artery) ( update )
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Case 32: ICA stenosis
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Image 4 DSA (angiography) (Common carotid artery) ( update )
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Case 32: Post Stentingpost stenting
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Image 5 CT (Planning image) ( update )
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Case 2 3
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