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Neurointervention 2006;1(1):7-17.
Atherosclerotic Carotid Stenosis: Recent Update of Carotid Stenting.
Hyun Jeong Kim, Dae Chul Suh
1Department of Radiology, Eulji University Hsopital, Korea.
2Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Korea. dcsuh@amc.seoul.kr
Atherosclerotic carotid stenosis, as a major cause of stroke, increases in Korea due to westernized eating habit and increasing proportion of elderly people. Since carotid endarterectomy (CEA) has been proven to be beneficial to the medical treatment only, carotid artery stenting (CAS) revealed the results not inferior to CEA. Currently, the advent of Anti-Embolic devices (or protection devices) and accumulating evidence supports the safety and efficacy of these strategies in minimizing the risk of embolization during the procedure. Particularly important are the recent reports of two randomized trials (CAVATAS and SAPPHIRE) that demonstrated favorable outcomes of stenting as compared to CEA. Growing evidence also supports the late efficacy of CAS in preventing stroke resulting from obstructive extracranial carotid artery disease. This review summarized the results of published randomized trials and the directions of ongoing trials of revascularization treatment of atherosclerotic carotid artery stenosis. And the appropriate patient selection, current procedural technique and complications of CAS are also reviewed.
Key Words: Angioplasty; Carotid stenosis; Endovascular therapy; Stents
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