Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical...
For lesions in the common femoral artery, guidelines recommend surgical endarterectomy (TEA) as the gold standard. However, endovascular therapy (EVT) is an alternative option for these lesions. In 2017 the first randomized study comparing TEA vs EVT was carried out, showing that EVT presents clinical benefits, though it does not replace surgical treatment as first...
The ACST-2 was designed to compare long-term outcomes of carotid artery stenting (CAS) vs carotid endarterectomy (CEA) in patients with asymptomatic stenosis. Prior to this study we had the German registry including 18,000 patients undergoing CAS and 86,000 receiving CEA between 2014 and 2019. At 30 days, disabling stroke rate was 0.7% for both strategies....
Cardiac complications are among the most frequent in patients undergoing carotid endarterectomy for asymptomatic lesions. This excess of cardiac events in patients with no neurological symptoms of carotid stenosis is essential to balance the risk/benefit ratio of carotid endarterectomy. A routine cardiology consultation prior surgery could reduce perioperative infarction rate, general complications and even mortality. ...
This prospective study analyzed patients with critical lower limb ischemia (due to complex, multiple lesions in several places) who were treated uniformly with common femoral artery endarterectomy combined with angioplasty to improve inflow and/or outflow. This hybrid treatment, which must be carried out by a team, can be greatly beneficial for this high-risk patient group...
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. Christopher White, entitled “ How to Choose Between Carotid Stenting and Carotid Endarterectomy for Stroke Prevention”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.f
The comparative efficacy and safety of carotid stenting vs. endarterectomy in asymptomatic carotid stenosis patients remains controversial and, what is worse, consensus seems unlikely in the near future. Given the lack of definite evidence, several meta-analyzis and systematic reviews have been produced in an attempt to shed some light on this matter. This study included all...
Patients with symptomatic stenosis of the internal carotid artery benefit from early intervention. The challenge lies in what intervention to choose. Most studies comparing endarterectomy to carotid stenting are fairly heterogeneous as regards timing of intervention. This element is key to comparing between procedures, since there is no doubt timing will directly affect results. ...
Complex vascular anatomy could increase the risk of periprocedural stroke during carotid artery stenting (CAS). However, no randomize study has provided evidence showing this potential difficulty should inform the choice between carotid stenting and endarterectomy. This study included 184 patients with symptomatic lesions of the internal carotid randomized to CAS vs. endarterectomy in the context...
There have been several studies offering contradictory data on the relative effectiveness of carotid artery stenting and carotid artery endarterectomy for the prevention of stroke due to carotid artery stenosis. The authors of this study performed a meta-analysis assessing the efficacy of these techniques, given recently published clinical trial data. They selected randomized...