Carotid artery stenting – history, trends and innovations

Czech version

Authors: Miloslav Špaček; Josef Veselka
Authors‘ workplace: Kardiologická klinika 2. LF UK a FN Motol Praha, přednosta prof. MUDr. Josef Veselka, CSc., FESC, FSCAI, FICA
Published in: Vnitř Lék 2014; 60(12): 1072-1075
Category: 70. birthday prof. MUDr. Michael Aschermann, DrSc., FESC, FACC

Overview

Surgical carotid endarterectomy is traditionally considered the standard approach for the treatment of atherosclerotic carotid artery disease based on its long history of favorable outcomes. Many of the patients could, however, be offered carotid artery stenting (CAS), which has over time evolved into an elaborate method. With proper selection of patients, CAS provides comparable long-term outcomes and very low risk of periprocedural complication. This article summarises the current knowledge, trends and innovations in CAS.

Keywords:
carotid artery stenting – carotid endarterectomy – protection systems – transcranial doppler

Sources

1. Donnan GA, Fisher M, Macleod M et al. Stroke. Lancet 2008; 371(9624): 1612–1623.

2. Towfighi A, Saver JL. Stroke declines from third to fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke 2011; 42(8): 2351–2355.

3. Sacco RL, Kargman DE, Gu Q et al. Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke 1995; 26(1): 14–20.

4. Ringleb PA, Allenberg J, Bruckmann H et al. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet 2006; 368(9543): 1239–1247.

5. Mas JL, Chatellier G, Beyssen B et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med 2006; 355(16): 1660–1671.

6. DeBakey ME. Carotid endarterectomy revisited. J Endovasc Surg 1996; 3(1): 4.

7. Eastcott HH, Pickering GW, Rob CG. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplagia. Lancet 1954; 267(6846): 994–996.

8. Warlow CP. Carotid endarterectomy: does it work? Stroke 1984; 15(6): 1068–1076.

9. Mathias K. Perkutane transluminale Katheterbehandlung supraaortaler Arterienobstruktionen. Angio 1981; 3: 47–50.

10. North American Symptomatic Carotid Artery Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 1991; 325(7): 445–453.

11. European Carotid Surgery Trialists´ Collaborative Group. MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or mild (0–29%) carotid stenosis. Lancet 1991; 337(8752): 1235–1243.

12. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA 1995; 273(18): 1421–1428.

13. Halliday AW, Thomas D, Mansfield A. The Asymptomatic Carotid Surgery Trial (ACST). Rationale and design. Steering Committee. Eur J Vasc Surg 1994; 8(6): 703–710.

14. Brott TG, Hobson RW 2nd, Howard G et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 2010; 363(1): 11–23.

15. Bryant MF. Anatomic considerations in carotid endarterectomy. Surg Clin North Am 1974; 54(6): 1291–1296.

16. Hans SS, Shah S, Hans B. Carotid endarterectomy for high plaques. Am J Surg 1989; 157(4): 431–434.

17. Favre JP, Nourissat A, Duprey A et al. Association Universitaire de Recherche en Chirurgie Vasculaire. Endovascular treatment for carotid artery stenosis after neck irradiation. J Vasc Surg 2008; 48(4): 852–858.

18. White CJ, Ramee SR, Collins TJ et al. Carotid artery stening: patient, lesion, and procedural characteristics that increase procedural complications. Catheter Cardiovasc Interv 2013; 82(5): 715–726.

19. Saba L, Anzidei M, Marincola BC et al. Imaging of the carotid artery vulnerable plaque. Cardiovasc Intervent Radiol 2014; 37(3): 572–585.

20. Markus HS, King A, Shipley M et al. Asymptomatic embolisation for prediction of stroke in the Asymptomatic Carotid Emboli Study (ACES): a prospective observational study. Lancet Neurol 2010; 9(7): 663–667.

21. Štechovský C, Horváth M, Hájek P et al. Význam vulnerabilních aterosklerotických plátů a možnosti jejich detekce pomocí intravaskulární spektroskopie. Vnitř Lék 2014; 60(4): 375–379.

22. Veselka J, Cerna D, Zimolova P et al. Thirty-day outcomes of direct carotid artery stenting with cerebral protection in high-risk patients. Circ J 2007; 71(9): 1468–1472.

23. Schillinger M, Dick P, Wiest G et al. Covered versus bare self-expanding stents for endovascular treatment of carotid artery stenosis: a stopped randomized trial. J Endovasc Ther 2006; 13(3): 312–319.

24. Schillinger M, Gschwendtner M, Reimers B et al. Does carotid stent cell design matter? Stroke 2008; 39(3): 905–909.

25. Jordan WD Jr, Voellinger DC, Doblar DD et al. Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterectomy. Cardiovasc Surg 1999; 7(1): 33–38.

26. Ackerstaff RG, Suttorp MJ, van den Berg JC et al. Prediction of early cerebral outcome by transcranial Doppler monitoring in carotid bifurcation angioplasty and stenting. J Vasc Surg 2005; 41(4): 618–624.

27. Kastrup A, Gröschel K, Krapf H et al. Early outcome of carotid angioplasty and stenting with and without cerebral protection devices: a systematic review of the literature. Stroke 2003; 34(3): 813–819.

28. Montorsi P, Caputi L, Galli S et al. Microembolization during carotid artery stenting in patients with high-risk, lipid-rich plaque. A randomized trial of proximal versus distal cerebral protection. J Am Coll Cardiol 2011; 58(16): 1656–1663.

29. Spacek M, Veselka J. Microembolization following balloon deflation during proximally protected carotid artery stenting – a potential focus of procedure improvement? Catheter Cardiovasc Interv 2013; 83(7): 1185–1186.

30. Stabile E, Biamino G, Sorropago G et al. Proximal endovascular occlusion for carotid artery stenting. J Cardiovasc Surg (Torino) 2013; 54(1): 41–45.