Carotid endarterectomy continues to be the safest technique for emergency revascularization. However, 48 hours after index event, different strategy outcomes will become comparable. Multiple advances in device development have brought promising results for carotid revascularization patients with symptomatic stenosis. Regardless these developments, optimal revascularization timing after index event remains unclear. This study included patients with...
A significative lesion to the carotid artery in addition to contralateral carotid occlusion is an obvious factor of high risk for a revascularization procedure. However, this might be true for surgery but not for carotid artery stenting according to this recent publication in JACC. The presence of contralateral carotid occlusion has been established as high...
Advancements in therapies to reduce the impact of stroke in asymptomatic carotid artery stenosis have been hard to come by over the last decade. Several points of disagreement among published randomized trials prevented their information from being integrated into daily clinical practice. However, over the past 5 years, there has been some alignment, allowing for this...
Courtesy of Dr. Carlos Fava. In modern studies, carotid artery stenting (CAS) has been shown equal to surgery in terms of the composite end point of periprocedural stroke, death, acute myocardial infarction and late ipsilateral stroke. This was tested in different groups and by trained operators. In the CREST-2 Registry (C2R) 2141 patients were included,...
Courtesy of Dr. Carlos Fava. Carotid artery stenting (CAS) with a cerebral protection system has emerged as an alternative to surgery, particularly for patients with high surgical risk. Nowadays, there are a considerable number of cerebral protection systems, but these may sometimes fail due to anatomical issues, the diameter of embolized particles, or placement difficulties (among...
This study shows the benefit of reducing waiting time between acute events and intervention in patients with severe symptomatic carotid stenosis. Its outcomes support the efforts to reduce patient management. Moreover, it could be used as an indicator of clinical practice quality. The risk of recurrent events after an ischemic event is significantly higher in...
Myocardial revascularization surgery (CABG) is the most frequent of all cardiovascular surgeries and is still the gold standard to treat multivessel disease. Between 6 and 8% of these patients present concomitant carotid stenosis and it is associated with increased peri and post procedural stroke rates during and after surgery. To prevent carotid stenosis, either PCI or endarterectomy...
Courtesy of Dr. Carlos Fava. Carotid artery disease is an important cause of stroke and is associated to coronary artery disease. When patients need myocardial revascularization surgery (Carotid Artery Bypass Graft) and cannot wait one month or more for carotid revascularization, the optimal management strategy is still controversial. The aim of this study was...
Remote ischemic preconditioning (RIPC) can prevent recurrent ischemic events in patients with acute or chronic cerebral ischemia. However, is remains unclear whether RIPC could prevent an ischemic event in the context of carotid PCI in patients with severe carotid artery stenosis. The study included patients with severe carotid artery stenosis randomized to RIPC, vs....
There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients. This registry included prospective data with a strict follow up protocol on 901...