[en] We report the case of a 70-year old man treated by surgery and radiotherapy for a neoplasic lesion of the tongue in whom severe symptomatic stenosis of the left internal carotid artery occurred a few years later. This lesion was successfully treated by percutaneous carotid angioplasty and stenting with distal embolic protection (PCAS). After a period of experimenting with angioplasty and stenting, PCAS is becoming a serious alternative for carotid thrombo-endarterectomy (TEA). Indications for PCAS are currently patients who, due to several reasons, are no good candidates for surgery. Several of large PCAS versus TEA randomized trials are underway and final results will help us determine the best indication for TEA or PCAS for both low and high risk patients with symptomatic or asymptomatic carotid stenosis.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Martinez, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
LEGRAND, Victor ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Sprynger, Muriel ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie
Garweg, Ch; Service de Gériatrie, CHU Sart Tilman, Liège, Belgium
Petermans, J; Service de Cardiologie, CHU Sart-Tilman, 4000 Liège, Belgium
Pierard, Luc ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Cardiologie - Pathologie spéciale et réhabilitation
Language :
French
Title :
Sténose carotidienne mixte post-radique et athérosclérotique traitée par stenting carotidien protégé.
Alternative titles :
[en] Post-radiotherapy and atherosclerotic stenosis of the internal carotid artery treated by angioplasty and stenting.
Publication date :
March 2006
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Be
North American Symptomatic Carotid Endarterectomy Trial collaborators.- Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med, 1991, 325, 445-453.
Executive Committee for the Asymptomatic Carotid Atherosclerosis Study.- Endarterectomy for Asymptomatic Carotid Artery Stenosis. JAMA, 1995, 273, 1421-1428.
European Carotid Surgery Trialists' Collaborative group.- Randomised trial of endartectomy of recently symptomatic carotid stenosis: Final results of MRC European Carotid Surgery Trial (ECST). Lancet, 1998, 351, 1379-1387.
MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative group - Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet, 2004, 363, 1491-1502.
Van Damme H, Limet R.- Analyse des résultats des principales études randomisées d'endartériectomie carotidienne pour sténoses asymptomatiques. Rev Med Liege, 2005, 60, 811-813
Bock RW, Gray-Weale AC, Mock PA, et al.- The natural history of asymptomatic carotid artery disease. J Vasc Surg, 1993, 17, 160-169; discussion 170-171.
Felberg RA, Christou I, Demchuk AM, et al.- Screening for intracranial stenosis with transcranial Doppler: the accuracy of mean flow velocity thresholds. J Neuroimaging, 2002, 12, 9-14.
Bornstein NM, Gur AY, Geyer O, Almog Y.- Vasomotor reactivity in the ophthalmic artery: different from or similar to intracerebral vessels? Eur J Ultrasound, 2000, 11, 1-6.
Henderson RD, Eliasziw M, Fox AJ, et al.- Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. Stroke, 2000, 31, 128-132.
AbuRahma AF, Wulu JT Jr, Crotty B.- Carotid plaque ultrasonic heterogeneity and severity of stenosis. Stroke, 2002, 33, 1772-1775.
Tejada J, Diez-Tejedor E, Hernandez-Echebarria E, Balboa O.- Does a relationship exist between carotid stenosis and lacunar infarction? Stroke, 2003, 34, 1404-1409
Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet, 2001, 357, 1729-1737.
Wholey MH, Al-Mubarek N.- Updated review of the global carotid artery stent registry. Catheter Cardiovasc Interv, 2003, 60, 259-266.
Yadav JS, Wholey MH, Kuntz RE, et al.- Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators. (SAPPHIRE). Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med, 2004, 351, 1493-1501.
Limet R.- SAPPHIRE: Pierre précieuse ou ersatz? Rev Med Liege, 2005, 60, 683-688
Ringleb PA, Kunze A, Allenberg JR, et al.- Steering Committee of the SPACE Study. The Stent-Supported Percutaneous Angioplasty of the Carotid Artery vs. Endarterectomy Trial (SPACE). Cerebrovasc Dis, 2004, 18, 66-68.
Feartherstone RL, Brown MM, Coward LJ.- ICSS investigators. International carotid stenting study: protocol for a randomised clinical trial comparing carotid stenting with endarterectomy in symptomatic carotid artery stenosis. Cerebrovasc Dis, 2004, 18, 69-74
Hobson RW 2nd, Howard VJ, Roubin GS, et al.- CREST investigators - Carotid artery stenting is associated with increased complications in octogenarians: 30-day stroke and death rates in the CREST lead-in phase. J Vasc Surg, 2004, 40, 1106-1111.
Carotid revascularization using endarterectomy or stenting systems (CARESS): phase I clinical trial. J Endovasc Ther, 2003, 12, 1021-1030.
Gray WA, White HJ Jr, Barrett DM, et al.- Carotid stenting and endarterectomy: a clinical and cost comparison of revascularization strategies. Stroke, 2002, 33, 1063-1070.
Levin DC, Becker GJ, Dorros G, et al.- Councils on Cardiovascular Radiology, Cardiothoracic and Vascular Surgery, and Clinical Cardiology, American Heart Association. Training standards for physicians performing peripheral angioplasty and other percutaneous peripheral vascular interventions. J Vasc Interv Radiol, 2003, 9, S359-361.
