Title: Carotid artery stenting: Current state of evidence and future directions
Abstract: Acta Neurologica ScandinavicaVolume 139, Issue 4 p. 318-333 REVIEW ARTICLE Carotid artery stenting: Current state of evidence and future directions Anthony Lamanna, Corresponding Author Anthony Lamanna [email protected] orcid.org/0000-0003-0705-2252 Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Correspondence Anthony Lamanna and Julian Maingard, Austin Hospital, Heidelberg, Vic., Australia. Emails: [email protected]; [email protected] for more papers by this authorJulian Maingard, Corresponding Author Julian Maingard [email protected] Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Correspondence Anthony Lamanna and Julian Maingard, Austin Hospital, Heidelberg, Vic., Australia. Emails: [email protected]; [email protected] for more papers by this authorChristen D. Barras, Christen D. Barras South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia The University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorHong Kuan Kok, Hong Kuan Kok Interventional Radiology Service, Northern Hospital Radiology, Melbourne, Victoria, Australia School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, AustraliaSearch for more papers by this authorGuy Handelman, Guy Handelman Education and Research Centre, Beaumont Hospital, Dublin, Ireland Department of Radiology, Royal Victoria Hospital, Belfast, UKSearch for more papers by this authorRonil V. Chandra, Ronil V. Chandra Department of Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, AustraliaSearch for more papers by this authorVincent Thijs, Vincent Thijs Stroke Division, The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Victoria, Australia The University of Melbourne, Melbourne, Victoria, Australia Department of Neurology, Austin Health, Melbourne, Victoria, AustraliaSearch for more papers by this authorDuncan Mark Brooks, Duncan Mark Brooks Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Interventional Neuroradiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, AustraliaSearch for more papers by this authorHamed Asadi, Hamed Asadi Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia Department of Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, AustraliaSearch for more papers by this author Anthony Lamanna, Corresponding Author Anthony Lamanna [email protected] orcid.org/0000-0003-0705-2252 Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Correspondence Anthony Lamanna and Julian Maingard, Austin Hospital, Heidelberg, Vic., Australia. Emails: [email protected]; [email protected] for more papers by this authorJulian Maingard, Corresponding Author Julian Maingard [email protected] Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Correspondence Anthony Lamanna and Julian Maingard, Austin Hospital, Heidelberg, Vic., Australia. Emails: [email protected]; [email protected] for more papers by this authorChristen D. Barras, Christen D. Barras South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia The University of Adelaide, Adelaide, South Australia, AustraliaSearch for more papers by this authorHong Kuan Kok, Hong Kuan Kok Interventional Radiology Service, Northern Hospital Radiology, Melbourne, Victoria, Australia School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, AustraliaSearch for more papers by this authorGuy Handelman, Guy Handelman Education and Research Centre, Beaumont Hospital, Dublin, Ireland Department of Radiology, Royal Victoria Hospital, Belfast, UKSearch for more papers by this authorRonil V. Chandra, Ronil V. Chandra Department of Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, AustraliaSearch for more papers by this authorVincent Thijs, Vincent Thijs Stroke Division, The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Victoria, Australia The University of Melbourne, Melbourne, Victoria, Australia Department of Neurology, Austin Health, Melbourne, Victoria, AustraliaSearch for more papers by this authorDuncan Mark Brooks, Duncan Mark Brooks Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia Interventional Neuroradiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, AustraliaSearch for more papers by this authorHamed Asadi, Hamed Asadi Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia Department of Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia Interventional Neuroradiology Service, Department of Radiology, Austin Hospital, Melbourne, Victoria, AustraliaSearch for more papers by this author First published: 04 January 2019 https://doi.org/10.1111/ane.13062Citations: 15Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) are common treatments for carotid artery stenosis. Several randomized controlled trials (RCTs) have compared CEA to CAS in the treatment of carotid artery stenosis. These studies have suggested that CAS is more strongly associated with periprocedural stroke; however, CEA is more strongly associated with myocardial infarction. Published long-term outcomes report that CAS and CEA are similar. A reduction in complications associated with CAS has also been demonstrated over time. The symptomatic status of the patient and history of previous CEA or cervical radiotherapy are significant factors when deciding between CEA or CAS. Numerous carotid artery stents are available, varying in material, shape and design but with minimal evidence comparing stent types. The role of cerebral protection devices is unclear. Dual antiplatelet therapy is typically prescribed to prevent in-stent thrombosis, and however, evidence comparing periprocedural and postprocedural antiplatelet therapy is scarce, resulting in inconsistent guidelines. Several RCTs are underway that will aim to clarify some of these uncertainties. In this review, we summarize the development of varying techniques of CAS and studies comparing CAS to CEA as treatment options for carotid artery stenosis. CONFLICT OF INTEREST All authors report no conflict of interest. Citing Literature Volume139, Issue4April 2019Pages 318-333 RelatedInformation