Few procedures in the history of medicine have been more controversial than carotid artery stenting (CAS) for the management of carotid artery occlusive disease. Introduced just as the randomized trials were establishing carotid endarterectomy as the gold standard for carotid interventions, CAS has finally reached the point in its development when dedicated stenting systems are being tested in randomized clinical trials. Assisted by the concomitant use of distal protection devices, CAS has shown equipoise with endarterectomy in terms of safety at 30 days. This review summarizes the completed and ongoing CAS trials and the applications of endovascular techniques in the supra-aortic vessels.
North American Symptomatic Carotid Endarterectomy Trial Collaborators.Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med.1991;325:445–453.
4.
Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995;273:1421–1428.
5.
Carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. National Institute of Neurological Disorders and Stroke. J Neurol Sci.1995;129:76–7.
6.
European Carotid Surgery Trialists' Collaborative Group.MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. Lancet. 1991;337:1235–1243.
7.
ChaturvediSAggarwalRMurugappanA. Results of carotid endarterectomy with prospective neurologist follow-up. Neurology. 2000;55:769–772.
8.
MathiasK. A new catheter system for percutaneous transluminal angioplasty (PTA) of carotid artery stenoses [in German]. Fortschr Med.1977;95:1007–1011.
9.
TheronJRaymondJCasascoA. Percutaneous angioplasty of atherosclerotic and postsurgical stenosis of carotid arteries. AJNR Am J Neuroradiol. 1987;8:495–500.
10.
KachelREndertGBascheS. Percutaneous transluminal angioplasty (dilatation) of carotid, vertebral and innominate artery stenoses. Cardiovasc Intervent Radiol. 1987;10:142–146.
11.
DiethrichEBNdiayeMReidDB. Stenting in the carotid artery: initial experience in 110 patients. J Endovasc Surg.1996;3:42–62.
12.
RoubinGSYadavSIyerSS. Carotid stent-supported angioplasty: a neurovascular intervention to prevent stroke. Am J Cardiol. 1996;78(suppl 3A):8–12.
MathiasKD. Angioplasty and stenting for carotid lesions: an argument for. Adv Surg.1999;32:225–243.
15.
VitekJIyerSRoubinG. Carotid stenting in 350 vessels: problems faced and solved. J Invasive Cardiol. 1998;10:311–314.
16.
YadavJSRoubinGSIyerSS. Elective stenting of the extracranial carotid arteries. Circulation. 1997;95:376–381.
17.
WholeyMHWholeyMHBergeronP. Current global status of carotid artery stent placement. Cathet Cardiovasc Diagn. 1998;44:1–6.
18.
CAVATAS Investigators. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001;357:1729–1737.
19.
WholeyMHWholeyMMathiasK. Global experience in cervical carotid artery stent placement. Catheter Cardiovasc Interv. 2000;50:160–167.
20.
WholeyMHAl-MubarekNWholeyMH. Updated review of the global carotid artery stent registry. Catheter Cardiovasc Interv. 2003;60:259–266.
21.
MooreWSBarnettHJMBeebeHG. Guidelines for carotid endarterectomy. A multidisciplinary consensus statement from the ad hoc Committee, American Heart Association. Stroke. 1995;26:188–201.
22.
SatlerLFLairdJR. Limiting the complications of carotid stenting. Catheter Cardiovasc Intervent. 2001;54:524–525.
23.
WholeyMHWholeyMHTanWA. A comparison of balloon-mounted and self-expanding stents in the carotid arteries: immediate and long-term results of more than 500 patients. J Endovasc Ther.2003;10:171–181.
24.
Al-MubarakNRoubinGSVitekJJ. Subarachnoidal hemorrhage following carotid stenting with the distal balloon protection. Catheter Cardiovasc Intervent. 2001;54:521–523.
25.
McCabeDJBrownMMCliftonA. Fatal cerebral reperfusion hemorrhage after carotid stenting. Stroke. 1999;30:2483–2486.
26.
Willfort-EhringerAAhmadiRGschwandtnerME. Single-center experience with carotid stent restenosis. J Endovasc Ther.2002;9:299–307.
27.
YadavJSWholeyMHKuntzRE. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med.2004;351:1493–1501.
CARESS Steering Committee. Carotid revascularization with endarterectomy or stenting systems (CARESS): investigator selection. J Endovasc Ther.2001;8:547–549.
30.
CARESS Steering Committee. Carotid Revascularization using Endarterectomy or Stenting Systems (CARESS): phase I clinical trial. J Endovasc Ther.2003;10:1021–1030.
31.
WholeyMH. The ARCHeR trial: prospective clinical trial for carotid stenting in high surgical risk patients, preliminary thirty-day results. Presented at the 52nd Annual Meeting of the American College of Cardiology; March 30, 2003; Chicago, IL, USA.
32.
WhitlowPL. SECuRITY: Multicenter registry in high risk symptomatic and asymptomatic carotid disease with the Abbott Xact stent and MedNova filter. Presented at Transcatheter Cardiovascular Therapeutics (TCT); September 15–19, 2003; Washington, DC, USA.
33.
RameeS. MavericII. A prospective registry of carotid stenting with the Exponent stent and distal protection with the GuardWire in high risk patients: 30-day results. Presented at Transcatheter Cardiovascular Therapeutics (TCT); September 27–October 1, 2004; Washington, DC, USA.
34.
WhiteCJ. Beach trial: 30-day pivotal group results. Presented at 13th Annual Peripheral Angioplasty and All That Jazz; April 13–16, 2004; New Orleans, LA, USA.
35.
HopkinsLN. CABERNET: 30-day pivotal results. Presented at Transcatheter Cardiovascular Therapeutics (TCT); September 27–October 1, 2004; Washington, DC, USA.
36.
AdamiCAScuroASpinamanoL. Use of the Parodi Anti Embolism System in carotid stenting: Italian trial results. J Endovasc Ther.2002;9:147–154.
37.
KasirajanKSchneiderPAKentKC. Filter devices for cerebral protection during carotid angioplasty and stenting. J Endovasc Ther.2003;10:1039–1045.
38.
ThéronJ. Protected carotid angioplasty and carotid stents [in French]. J Mal Vasc.1996;21(suppl A):113–122.
39.
AhmadiRWillfortALangW. Carotid artery stenting: effect of learning curve and intermediate-term morphological outcome. J Endovasc Ther.2001;8:539–546.
40.
JaegerHJMathiasKDDrescherR. Diffusion-weighted MR imaging after angioplasty or angioplasty plus stenting of arteries supplying the brain. AJNR Am J Neuroradiol. 2001;22:1251–1259.
41.
JaegerHMathiasKDrescherR. Clinical results of cerebral protection with a filter device during stent implantation of the carotid artery. Cardiovasc Intervent Radiol. 2001;24:249–256.
42.
BrottTAdamsHPOlingerCP. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20:864–870.
43.
JunckLMarshallWH. Neurotoxicity of radiological contrast agents. Ann Neurol. 1983;13:469–484.
WholeyMHWholeyMHTanWA. Management of neurological complications of carotid artery stenting. J Endovasc Ther.2001;8:341–353.
46.
SatlerLFLairdJR. Limiting the complications of carotid stenting. Catheter Cardiovasc Intervent. 2001;54:524–525.
47.
AlexandrovAVWojnerAWGrottaJC. CLOTBUST: design of a randomized trial of ultrasound-enhanced thrombolysis for acute ischemic stroke. J Neuroimaging. 2004;14:108–112.
48.
PerlerBAWilliamsGM. Carotid-subclavian bypass—a decade of experience. J Vasc Surg.1990;12:716–723.
49.
AckermannHDienerHCSeboldtH. Ultrasonographic follow-up of subclavian stenosis and occlusion: natural history and surgical treatment. Stroke. 1988;19:431–435.
50.
WesterbandARodriguezJARamaiahVG. Endovascular therapy in prevention and management of coronary-subclavian steal. J Vasc Surg.2003;38:699–704.
HenryMAmorMHenryI. Percutaneous transluminal angioplasty of the subclavian arteries. J Endovasc Surg.1999;6:33–41.
53.
SchillingerMHaumerMSchillingerS. Outcome of conservative versus interventional treatment of subclavian artery stenosis. J Endovasc Ther.2002;9:139–146.
54.
SchoderMManfredCHolzenbeinT. Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries. J Endovasc Ther.2003;10:58–65.
55.
ReivichMHollingHRobertsB. Reversal of blood flow through vertebral artery and its effect on cerebral circulation. New Engl J Med.1961;265:878–885.
56.
SullivanTMGrayBHBacharachJM. Angioplasty and primary stenting of the subclavian, innominate, and common carotid arteries in 83 patients. J Vasc Surg.1998;28:1059–1065.
57.
KachelR. PTA of carotid, vertebral, and subclavian artery stenoses. An alternative to vascular surgery?Int Angiol. 1994;13:48–51.
58.
AllieDEHebertCJLirtzmanMD. Intraoperative innominate and common carotid intervention combined with carotid endarterectomy: a “true” endovascular surgical approach. J Endovasc Ther.2004;11:258–262.
PieniazekPMusialekPMotylR. Use of the Parodi Anti-Emboli System and transient subclavian steal for cerebral protection during emergent vertebral artery recanalization. J Endovasc Ther.2004;11:511–516.
61.
LinYHJuangJMJengJS. Symptomatic ostial vertebral artery stenosis treated with tubular coronary stents: clinical results and restenosis analysis. J Endovasc Ther.2004;11:719–726.
