All methods of arterial closure following a standard carotid endarterectomy (CEA) are associated with appreciable rates of persistent or recurrent internal carotid artery (ICA) stenoses, of which some are related to technical issues in closing the artery. Eversion endarterectomy of…
Carotid endarterectomy (CEA) is a conceptually simple but technically unforgiving surgical procedure. Although other factors like patient selection and preoperative antiplatelet therapy also play an important role, a good clinical outcome after CEA probably is related most directly to the…
Carotid endarterectomy (CEA) has been proved effective at reducing the risk of stroke in large-scale landmark clinical trials. These randomized trials have established indications for CEA in selected patients with symptomatic stenosis of 50% or more and asymptomatic stenosis of…
Cerebral hyperperfusion syndrome (CHS) and intracerebral hemorrhage are perhaps the most feared complications of carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS). Although relatively uncommon, such complications can have devastating and often fatal sequelae and remain a significant cause…
Endovascular treatment of carotid stenosis by way of balloon angioplasty and carotid artery stenting (CAS) may be accompanied by bradycardia or hypotension. The incidence of CAS-induced bradycardia varies widely in the literature, ranging from 5% to 76%. Similarly, the incidence…
The use of a cerebral protection device during carotid angioplasty and stenting (CAS) has been a component of most trials demonstrating the safety and efficacy of CAS, thereby suggesting that use of cerebral protection devices is standard practice. Currently, there…
Embolization to the brain is a universal occurrence during carotid artery stenting (CAS) procedures. This has been documented by several well conducted ex vivo studies, by the routine use of transcranial Doppler monitoring, and by analyzing the blood aspirated after…
Carotid angioplasty and stenting with cerebral protection has emerged as a minimally invasive alternative to endarterectomy and is a treatment option for carotid arteriosclerotic disease. Carotid angioplasty and stenting comprises the following steps: (1) preprocedural evaluation, (2) femoral access, (3)…
Carotid endarterectomy (CEA) has been shown to decrease the long-term risk of stroke compared with medical therapy. Percutaneous techniques such as carotid artery angioplasty with stenting (CAS) are less invasive and a viable option for the treatment of carotid artery…
Diabetes mellitus (DM) has been described as an epidemic in progress. By 2050 its prevalence among adults in the United States is predicted to increase from 1 in 10 to 1 in 5. Additionally, in the adolescent population its incidence…