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Interventional Management of Asymptomatic Extracranial Carotid Stenosis

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Abstract

Carotid artery stenosis is a major risk factor for stroke and transient ischemic attack. Although carotid endarterectomy is the established gold standard for carotid revascularization, carotid artery angioplasty and stenting (CAS)—proven by large randomized clinical trials and rigorous registries and supported by improving stent designs, embolic protection, and increasing neurointerventionalist experience—is developing into a safer and more efficacious method of stroke prevention. Today, protected CAS is approved for symptomatic and asymptomatic patients with severe carotid stenosis with high surgical risk. We reviewed recently published data regarding new developments in the use of protected CAS, particularly in patients with carotid stenosis who are either asymptomatic or at low surgical risk.

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Abbreviations

ACAS:

Asymptomatic Carotid Atherosclerosis Study

ACST:

Asymptomatic Carotid Surgery Trial

ACT-1:

Asymptomatic Carotid Stenosis, Stenting Versus Endarterectomy Trial

CABERNET:

Carotid Artery Revascularization Using the Boston Scientific FilterWire EX/EZ and the EndoTex NexStent

CAPTURE:

Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events

CaRESS:

Carotid Revascularization Using Endarterectomy or Stenting Systems

CREST:

Carotid Revascularization Endarterectomy Versus Stent

ECST:

European Carotid Surgery Trial

EVA-3S:

Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis

ICAROS:

Imaging in Carotid Angioplasty and Risk of Stroke

ICSS:

International Carotid Stenting Study

NASCET:

North America Symptomatic Carotid Endarterectomy Trial

SAPPHIRE:

Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy

SPACE:

Stent-Supported Percutaneous Angioplasty of the Carotid Artery Versus Endarterectomy

TACIT:

Transatlantic Asymptomatic Carotid Intervention Trial

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Authors and Affiliations

  1. Department of Neurology, University of Louisville School of Medicine, Room 114, 500 South Preston Street, Louisville, KY, 40202, USA

    Alex Abou-Chebl

  2. University of Louisville School of Medicine, Louisville, KY, USA

    Vincent V. Truong

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Correspondence to Alex Abou-Chebl.

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Truong, V.V., Abou-Chebl, A. Interventional Management of Asymptomatic Extracranial Carotid Stenosis. Curr Cardiol Rep 13, 30–37 (2011). https://doi.org/10.1007/s11886-010-0155-0

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