Carotid artery revascularization

Lai BK. (2007). Cognitive function after carotid artery revascularization. Vascular and Endovascular Surgery 41 5-13 Levi CR, O Malley HM, Fell G et al. (1997). Transcranial Doppler detected cerebral microembolism following carotid endarterectomy. High microembolic signal loads predict postoperative cerebral ischaemia. Brain 120 621-629 Lindblad B, Persson NH, Takolander R et al. (1993). Does low-dose acetylsalicylic acid prevent stroke after carotid surgery ... 

Aspry KE, Holcroft JW, Amsterdam EA. Physician recognition of hypercholesterolemia in patients undergoing peripheral and carotid artery revascularization. A J Preventive Med 1995 11 336-341. 

Jovin TG, Gupta R, Uchino K, Jungreis CA, Wechsler LR, Hammer MD, Tayal A, Horowitz MB. Emergent stenting of extracranial internal carotid artery occlusion in acute stroke has a high revascularization rate. Stroke 2005 36 2426-2430. 

Carotid revascularization, initially by CEA, was introduced in early 1950s as a method to prevent stroke due to atherosclerosis of the carotid bifurcation and internal carotid artery (ICA). At least four prospective randomized trials have demonstrated... 

Who Should be Considered for Screening for Asymptomatic CAS 166 Carotid Revascularization for Patients With Asymptomatic Carotid Artery Stenosis ... 

CAROTID REVASCULARIZATION FOR PATIENTS WITH ASYMPTOMATIC CAROTID ARTERY STENOSIS THE CONTROVERSY... 

This concern extends to carotid artery stenting. Although carotid artery stenting in patients with asymptomatic CAS can be performed by experienced operators with a low complication rate, the procedure can be associated with high complication rate if performed by inexperienced operators, particularly in older patients with complex anatomy (24). In any case, institution-specific assessment of the risk of carotid intervention, endarterectomy, or stenting should be a prime consideration in clinical decision making regarding carotid revascularization in patients with asymptomatic CAS. 

Salasidis GC, Latter DA, Steinmetz OK, Blair JF, Graham AM. Carotid artery duplex scanning in preoperative assessment for coronary artery revascularization the association between peripheral vascular disease, carotid artery stenosis, and stroke. J Vase Surg 1995 21(l) 154-62. 

Lin R, Vora N, Zaidi S, Aleu A, Jankowitz B, Thomas A, Gupta R, Horowitz M, Kim S, Reddy V, Hammer M, Uchino K, Wechsler LR, Jovin T Mechanical approaches combined with intra-arterial pharmacological therapy are associated with higher recanalization rates than either intervention alone in revascularization of acute carotid terminus occlusion. Stroke 2009 40 pp. 2092-2097. 

Fortunately, an excellent alternative to open surgical management of CBS has become available, consisting at first of various endovascular techniques for occluding major brachiocephalic arteries [25,27,29-36]. Furthermore, within the last several years, endovascular revascularization techniques utilizing stent technology also have become more readily available, providing additional options for the successful treatment of CBS without sacrifice of the carotid circulation [37-43]. 

---