By Nadim Al-Mubarak MD, Gary S. Roubin MD PhD, Sriram S. Iyer MD, Jiri J. Vitek MD PhD

ISBN-10: 0781743850

ISBN-13: 9780781743853

Written through across the world famous specialists in interventional cardiology, this complete medical reference on carotid artery stenting offers illustrated, step by step descriptions of innovations and information on symptoms, contraindications, sufferer choice, problems, know-how, and medical trials. the 1st part studies scientific effects and adventure, together with the CAVATAS trial findings on stroke prevention. the second one part describes stenting recommendations and comprises info from significant trials on layout and alertness of units. The 3rd part provides directions and present laws on developing a carotid stenting application. The booklet concludes with a preview of destiny directions.

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Additional resources for Carotid Artery Stenting: Current Practice and Techniques

Example text

Neither endarterectomy nor stenting underwent extensive bench-top or animal studies before introduction into use in humans, and although with time thousands of patients were treated by angioplasty or stenting and indeed millions by endarterectomy, they were largely treated outside of randomized trials. In 1951, a patient with symptomatic thrombosis of the internal carotid artery (ICA) underwent surgical intervention with carotid-carotideal anastomosis (1). Following this, a patient with symptoms suggesting that a stroke was imminent underwent successful removal of a stenosed segment of the carotid artery (2).

There was independent review of outcomes, and asymptomatic patients were included. Information on restenosis and late ipsilateral stroke for the stent group was available at the 2-year follow-up. 5 m per second) in eight treated arteries. 4 m per second. Three of these patients had repeat percutaneous intervention, and one patient had endarterectomy with stent explantation; there were no clinical events arising from these secondary procedures. Between the 6- and 12-month evaluations, two additional stents had progression of neointimal hyperplasia on Doppler ultrasound.

Criticism appeared in the 1980s that the rates of perioperative strokes and deaths were unacceptably high and the indications often inappropriate. Between 1974 and 1985, approximately 1 million CEAs were performed worldwide with only anecdotal evidence of benefit. These unfavorable results stimulated critical neurologists and surgeons to start prospective, randomized clinical studies in Europe and the United States. Preliminary results of the European Carotid Surgery Trial (ECST) (7) and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) (8) in 1991 showed a benefit of surgery compared to medical treatment alone in selected patients.

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Carotid Artery Stenting: Current Practice and Techniques by Nadim Al-Mubarak MD, Gary S. Roubin MD PhD, Sriram S. Iyer MD, Jiri J. Vitek MD PhD

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