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Do we need a new carotid artery stenting trial?

Van Damme, Hendrik; Defraigne, Jean

2010 • In Acta Chirurgica Belgica, 110 (4), p. 432-44

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https://hdl.handle.net/2268/66038

DOI
10.1080/00015458.2010.11680652

PubMed
20919666

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Keywords :

Angioplasty, Balloon/adverse effects; Carotid Stenosis/surgery/therapy; Embolism; Endarterectomy, Carotid/adverse effects; Humans; Randomized Controlled Trials as Topic; Risk Assessment; Stroke/epidemiology; Treatment Outcome

Abstract :

[en] Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery stenting (CAS) over carotid artery endarterectomy (CEA). There is at the moment no level-I evidence to support widespread use of endovascular management of carotid artery disease in routine practice. In order to shead some light on the continuing debate on the role of carotid artery stenting, the authors conducted a search in contemporary published literature concerning carotid artery stenting. This extensive literature review reveals a higher peri-procedural stroke-death rate after CAS and a higher cost. Two other events hamper the value of CAS: a higher late restenosis rate and a higher risk of micro-embolisation during the procedure, compared with CEA. The authors conclude that the prevailing overenthusiasm of interventionalists (vascular surgeons, radiologists, cardiologists) for carotid artery stenting is not justified.

Disciplines :

Surgery

Author, co-author :

Van Damme, Hendrik ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire

Defraigne, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire

Language :

English

Title :

Do we need a new carotid artery stenting trial?

Publication date :

2010

Journal title :

Acta Chirurgica Belgica

ISSN :

1784-3421

eISSN :

2577-0160

Publisher :

Acta Medica Belgica, Bruxelles, Belgium

Volume :

110

Issue :

4

Pages :

432-44

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 25 February 2011

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