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Carotid artery stenting: Avoiding the perfect storm
Author(s) -
Safian Robert D.
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26819
Subject(s) - medicine , carotid endarterectomy , thrombus , stenosis , carotid stenting , stroke (engine) , endarterectomy , revascularization , cardiology , radiology , carotid arteries , myocardial infarction , mechanical engineering , engineering
Key Points Carotid artery stenting (CAS) and carotid artery endarterectomy (CEA) have achieved equipoise for most patients with carotid artery stenosis. Studies of outcomes after CAS and CEA must consider important patient and anatomic characteristics. A perfect storm for CAS is observed in a clinical scenario characterized by acute stroke, high likelihood for unstable plaque and thrombus, early revascularization, operator inexperience, and failure to use closed‐cell stents and embolic protection. Adverse outcomes in these situations are not shortcomings of CAS, but are due to poor clinical decision‐making and judgment.