HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Phatouros, C. C. Articles by Halbach, V. V. Search for Related Content PubMed PubMed Citation Articles by Phatouros, C. C. Articles by Halbach, V. V.

Carotid Artery Stent Placement for Atherosclerotic Disease: Rationale, Technique, and Current Status¹

¹ From the Division of Interventional Neurovascular Radiology, University of California–San Francisco Medical Center, Calif. Received May 18, 1999; revision requested July 16; revision received September 23; accepted October 12. Address correspondence to C.C.P., Interventional Neuroradiology Unit, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia 6001, Australia (e-mail: constantine.phatouros@rph.health.wa.gov.au).

Carotid arterial endarterectomy is considered to be the standard for the treatment of atherosclerotic carotid arterial occlusive disease. This has been validated with results of several randomized controlled trials in which its effectiveness has been demonstrated over that of the best nonsurgical therapy. In the past several years, however, carotid angioplasty with stent placement has emerged as a potential alternative to carotid endarterectomy. This article represents a critical examination of the rationale for carotid revascularization; the history of endovascular techniques for the treatment of carotid atherosclerosis, beginning with balloon angioplasty and evolving to the use of stents; and the evidence supporting the effectiveness of the endovascular approach. A brief description of the current technical aspects of carotid artery stent placement is presented. The future status of the endovascular approach will be determined with randomized trials in which carotid artery stent placement is directly compared with endarterectomy, as well as by the potential for further innovation and improvement in endovascular devices, technique, and safety.

Index terms: Brain, infarction, 10.78, 172.721 • Carotid arteries, interventional procedures, 172.1267 • Carotid arteries, stenosis or obstruction, 172.721 • State of the Art • Stents and prostheses, 172.1267

This article has been cited by other articles:

				A.C. Yi, E. Palmer, G.Y. Luh, J.P. Jacobson, and D.C. Smith Endovascular Treatment of Carotid and Vertebral Pseudoaneurysms with Covered Stents AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 983 - 987. [Abstract] [Full Text] [PDF]

				P. H. Kolh, L. Comte, V. Tchana-Sato, C. Honore, A. Kerzmann, M. Mauer, and R. Limet Concurrent coronary and carotid artery surgery: factors influencing perioperative outcome and long-term results Eur. Heart J., January 1, 2006; 27(1): 49 - 56. [Abstract] [Full Text] [PDF]

				M. J. Alberts, R. E. Latchaw, W. R. Selman, T. Shephard, M. N. Hadley, L. M. Brass, W. Koroshetz, J. R. Marler, J. Booss, R. D. Zorowitz, et al. Recommendations for Comprehensive Stroke Centers: A Consensus Statement From the Brain Attack Coalition Stroke, July 1, 2005; 36(7): 1597 - 1616. [Abstract] [Full Text] [PDF]

				S. P. Lownie, D. M. Pelz, D. H. Lee, S. Men, I. Gulka, and P. Kalapos Efficacy of Treatment of Severe Carotid Bifurcation Stenosis By Using Self-Expanding Stents without Deliberate Use of Angioplasty Balloons AJNR Am. J. Neuroradiol., May 1, 2005; 26(5): 1241 - 1248. [Abstract] [Full Text] [PDF]

				A. J. Martin, D. A. Saloner, T. P. L. Roberts, H. Roberts, O. M. Weber, W. Dillon, S. Cullen, V. Halbach, C. F. Dowd, and R. T. Higashida Carotid Stent Delivery in an XMR Suite: Immediate Assessment of the Physiologic Impact of Extracranial Revascularization AJNR Am. J. Neuroradiol., March 1, 2005; 26(3): 531 - 537. [Abstract] [Full Text] [PDF]

				H. G. Roh, H. S. Byun, J. W. Ryoo, D. G. Na, W.-J. Moon, B. B. Lee, and D.-I. Kim Prospective Analysis of Cerebral Infarction After Carotid Endarterectomy and Carotid Artery Stent Placement by Using Diffusion-Weighted Imaging AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 376 - 384. [Abstract] [Full Text] [PDF]

				B. E. Cil, E. Akpinar, B. Peynircioglu, and S. Cekirge Utility of Covered Stents for Extracranial Internal Carotid Artery Stenosis AJNR Am. J. Neuroradiol., August 1, 2004; 25(7): 1168 - 1171. [Abstract] [Full Text] [PDF]

				N. Ghosh, D. Tampieri, and D. Melancon Immediate Evaluation of Angioplasty and Stenting Results in Supra-Aortic Arteries by Use of a Doppler-Tipped Guidewire AJNR Am. J. Neuroradiol., August 1, 2004; 25(7): 1172 - 1176. [Abstract] [Full Text] [PDF]

				R. T. Higashida, P. M. Meyers, C. C. Phatouros, J. J. Connors III, J. D. Barr, D. Sacks, and for the Technology Assessment Committees of the Am Reporting Standards for Carotid Artery Angioplasty and Stent Placement Stroke, May 1, 2004; 35(5): e112 - e134. [Full Text] [PDF]

				N. Tanaka, J.-B. Martin, K. Tokunaga, T. Abe, Y. Uchiyama, N. Hayabuchi, J. Berkefeld, and D. A. Rufenacht Conformity of Carotid Stents with Vascular Anatomy: Evaluation in Carotid Models AJNR Am. J. Neuroradiol., April 1, 2004; 25(4): 604 - 607. [Abstract] [Full Text] [PDF]

				W. S. Lesley, J. C. Chaloupka, J. B. Weigele, S. Mangla, and M. A. Dogar Preliminary Experience with Endovascular Reconstruction for the Management of Carotid Blowout Syndrome AJNR Am. J. Neuroradiol., May 1, 2003; 24(5): 975 - 981. [Abstract] [Full Text] [PDF]

				S. Muller-Hulsbeck, J. Grimm, C. Liess, J. Hedderich, M. Bergmeyer, and M. Heller Comparison and Modification of Two Cerebral Protection Devices Used for Carotid Angioplasty: In Vitro Experiment Radiology, October 1, 2002; 225(1): 289 - 294. [Abstract] [Full Text] [PDF]

				S. Binaghi, R. Chapot, A. Rogopoulos, and E. Houdart Carotid stenting of chronic cervical dissecting aneurysm: A report of two cases Neurology, September 24, 2002; 59(6): 935 - 937. [Abstract] [Full Text] [PDF]

				H. P. M. van Heesewijk, J. A. Vos, E. S. Louwerse, J. C. van den Berg, T. T. C. Overtoom, S. M. P. G. Ernst, H. W. Mauser, F. L. Moll, and R. G. A. Ackerstaff New Brain Lesions at MR Imaging after Carotid Angioplasty and Stent Placement Radiology, August 1, 2002; 224(2): 361 - 365. [Abstract] [Full Text] [PDF]

				A. Angelini, B. Reimers, M. D. Barbera, S. Sacca, G. Pasquetto, C. Cernetti, M. Valente, P. Pascotto, and G. Thiene Cerebral Protection During Carotid Artery Stenting: Collection and Histopathologic Analysis of Embolized Debris Stroke, February 1, 2002; 33(2): 456 - 461. [Abstract] [Full Text] [PDF]

				J. Berkefeld, B. Turowski, A. Dietz, H. Lanfermann, M. Sitzer, T. Schmitz-Rixen, H. Steinmetz, and F. E. Zanella Recanalization Results after Carotid Stent Placement AJNR Am. J. Neuroradiol., January 1, 2002; 23(1): 113 - 120. [Abstract] [Full Text] [PDF]

				G. Orlandi, S. Fanucchi, C. Fioretti, G. Acerbi, M. Puglioli, R. Padolecchia, F. Sartucci, and L. Murri Characteristics of Cerebral Microembolism During Carotid Stenting and Angioplasty Alone Arch Neurol, September 1, 2001; 58(9): 1410 - 1413. [Abstract] [Full Text] [PDF]

				S. N. Goldberg, P. F. Saldinger, G. S. Gazelle, J. C. Huertas, K. E. Stuart, T. Jacobs, and J. B. Kruskal Percutaneous Tumor Ablation: Increased Necrosis with Combined Radio-Frequency Ablation and Intratumoral Doxorubicin Injection in a Rat Breast Tumor Model Radiology, August 1, 2001; 220(2): 420 - 427. [Abstract] [Full Text] [PDF]