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Steno-occlusive Carotid Artery Disease: Carotid Artery Stenting Technique

  • Vernard S. FennellEmail author
  • Sabareesh K. Natarajan
  • Adnan H. Siddiqui
Chapter

Abstract

Carotid artery stenting is a crucial aspect in the armamentarium needed for comprehensive management of steno-occlusive carotid artery disease. Understanding the principles for patient selection, intraprocedural implications, and the various technical nuances is helpful in successful treatment. Here we present an analysis of these key factors in the endovascular treatment of carotid stenosis.

Keywords

Carotid artery stenosis Carotid stenting Digital subtraction angiography Embolic protection Steno-occlusive carotid artery disease Carotid endarterectomy 

References

  1. 1.
    Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Despres JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jimenez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133:e38–360.Google Scholar
  2. 2.
    Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. National Center for Health Statistics Data Brief. No. 267. US Department of Health and Human Services. https://wwwcdcgov/nchs/data/databriefs/db267pdf. Accessed 19 June 2017.
  3. 3.
    Kolominsky-Rabas PL, Weber M, Gefeller O, Neundoerfer B, Heuschmann PU. Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study. Stroke. 2001;32:2735–40.CrossRefGoogle Scholar
  4. 4.
    Liapis CD, Bell PR, Mikhailidis D, Sivenius J, Nicolaides A, Fernandes e Fernandes J, Biasi G, Norgren L. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur J Vasc Endovasc Surg. 2009;37:1–19.CrossRefGoogle Scholar
  5. 5.
    Prati P, Vanuzzo D, Casaroli M, Di Chiara A, De Biasi F, Feruglio GA, Touboul PJ. Prevalence and determinants of carotid atherosclerosis in a general population. Stroke. 1992;23:1705–11.CrossRefGoogle Scholar
  6. 6.
    Barnett HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, Rankin RN, Clagett GP, Hachinski VC, Sackett DL, Thorpe KE, Meldrum HE, Spence JD. For the North American symptomatic carotid endarterectomy trial collaborators. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. N Engl J Med. 1998;339:1415–25.CrossRefGoogle Scholar
  7. 7.
    European Carotid Surgery Trialists’ Collaborative Group. MRC European carotid surgery trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. Lancet. 1991;337:1235–43.CrossRefGoogle Scholar
  8. 8.
    European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351:1379–87.CrossRefGoogle Scholar
  9. 9.
    Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–8.CrossRefGoogle Scholar
  10. 10.
    Halliday A, Mansfield A, Marro J, Peto C, Peto R, Potter J, Thomas D. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet. 2004;363:1491–502.CrossRefGoogle Scholar
  11. 11.
    North American Symptomatic Carotid Endaretectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–53.CrossRefGoogle Scholar
  12. 12.
    Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, Bajwa TK, Whitlow P, Strickman NE, Jaff MR, Popma JJ, Snead DB, Cutlip DE, Firth BG, Ouriel K. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–501.CrossRefGoogle Scholar
  13. 13.
    Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11–23.CrossRefGoogle Scholar
  14. 14.
    Brott TG, Howard G, Roubin GS, Meschia JF, Mackey A, Brooks W, Moore WS, Hill MD, Mantese VA, Clark WM, Timaran CH, Heck D, Leimgruber PP, Sheffet AJ, Howard VJ, Chaturvedi S, Lal BK, Voeks JH, Hobson RW 2nd. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016;374:1021–31.CrossRefGoogle Scholar
  15. 15.
    CAVATAS Investigators. Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001;357:1729–37.CrossRefGoogle Scholar
  16. 16.
    Diethrich E, Fogarty TJ, Zarins CK, Hopkins LN, Roubin GS, Wholey MH, Nimsky S, McKinlay S, Siami FS. CaRESS: carotid revascularization using endarterectomy or stenting systems. Tech Vasc Interv Radiol. 2004;7:194–5.CrossRefGoogle Scholar
  17. 17.
    Gahremanpour A, Perin EC, Silva G. Carotid artery stenting versus endarterectomy: a systematic review. Tex Heart Inst J. 2012;39:474–87.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Hill MD, Brooks W, Mackey A, Clark WM, Meschia JF, Morrish WF, Mohr JP, Rhodes JD, Popma JJ, Lal BK, Longbottom ME, Voeks JH, Howard G, Brott TG, CREST Investigators. Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Circulation. 2012;126:3054–61.CrossRefGoogle Scholar
  19. 19.
    Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG, CREST Investigators. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke. 2010;41:S31–4.CrossRefGoogle Scholar
  20. 20.
    Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, Larrue V, Lievre M, Leys D, Bonneville JF, Watelet J, Pruvo JP, Albucher JF, Viguier A, Piquet P, Garnier P, Viader F, Touze E, Giroud M, Hosseini H, Pillet JC, Favrole P, Neau JP, Ducrocq X, EVA-3S Investigators. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–71.CrossRefGoogle Scholar
  21. 21.
    Ringleb PA, Allenberg J, Bruckmann H, Eckstein HH, Fraedrich G, Hartmann M, Hennerici M, Jansen O, Klein G, Kunze A, Marx P, Niederkorn K, Schmiedt W, Solymosi L, Stingele R, Zeumer H, Hacke W, SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet. 2006;368:1239–47.CrossRefGoogle Scholar
  22. 22.
    Timaran CH, Mantese VA, Malas M, Brown OW, Lal BK, Moore WS, Voeks JH, Brott TG, Investigators C () CREST Investigators. 2013 Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). J Vasc Surg 57:303–308.CrossRefGoogle Scholar
  23. 23.
    Zarins CK, White RA, Diethrich EB, Shackelton RJ, Siami FS, CaRESS Investigators. Carotid revascularization using endarterectomy or stenting systems (CaRESS): 4-year outcomes. J Endovasc Ther. 2009;16:397–409.CrossRefGoogle Scholar
  24. 24.
    Moore WS, Barnett HJ, Beebe HG, Bernstein EF, Brener BJ, Brott T, Caplan LR, Day A, Goldstone J, Hobson RW 2nd, et al. Guidelines for carotid endarterectomy. A multidisciplinary consensus statement from the ad hoc committee, American Heart Association. Stroke. 1995;26:188–201.CrossRefGoogle Scholar
  25. 25.
    Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL, Cates CU, Creager MA, Fowler SB, Friday G, Hertzberg VS, McIff EB, Moore WS, Panagos PD, Riles TS, Rosenwasser RH, Taylor AJ. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary <span class=“subtitle”>A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery <em>Developed in Collaboration With the American Academy of Neurology and Society of Cardiovascular Computed Tomography</em></span> 2011;57:1002–1044.Google Scholar
  26. 26.
    White CJ, Jaff MR. Catch-22: carotid stenting is safe and effective (Food and drug administration) but is it reasonable and necessary (Centers for Medicare and Medicaid Services)? J Am Coll Cardiol Intv. 2012;5:694–6.CrossRefGoogle Scholar
  27. 27.
    US Food and Drug Administration. Meeting materials of the circulatory system device advisory panel; 2017. https://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/CirculatorySystemDevicesPanel/ucm542254.htm. Accessed 19 June 2017: in Department of Health and Human Services.
  28. 28.
    Centers for Medicare and Medicaid Services. Decision memo for Percutaneous Transluminal Angioplasty (PTA) of the carotid artery concurrent with stenting (CAG-00085R3), p. 1–49. April 30, 2007. https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=194&ver=16&NcaName=Percutaneous+Transluminal+Angioplasty+(PTA)+of+the+Carotid+Artery+Concurrent+with+Stenting+(3rd+Recon)&bc=BEAAAAAAEAAA&&fromdb=true. Accessed 19 June 2017: in CMS.gov, Centers for Medicare and Medicaid Services, p. 1–49.
  29. 29.
    Weiner S. “I Can’t afford that!”: dilemmas in the care of the uninsured and underinsured. J Gen Intern Med. 2001;16:412–8.CrossRefGoogle Scholar
  30. 30.
    Lin PH, Barshes NR, Annambhotla S, Huynh TT. Prospective randomized trials of carotid artery stenting versus carotid endarterectomy: an appraisal of the current literature. Vasc Endovasc Surg. 2008;42:5–11.CrossRefGoogle Scholar
  31. 31.
    Ricotta JJ 2nd, Malgor RD. A review of the trials comparing carotid endarterectomy and carotid angioplasty and stenting. Perspect Vasc Surg Endovasc Ther. 2008;20:299–308.CrossRefGoogle Scholar
  32. 32.
    Alberts MJ, Publications Committee of WALLSTENT. Results of a multicenter prospective randomized trial of carotid artery stenting vs. carotid endarterectomy (abstract 53). Stroke. 2001;32:325.CrossRefGoogle Scholar
  33. 33.
    Alberts MJ, McCann R, Smith TP, Stack R, Roubin G, Schneck M, Haumschild D, Iyer S, Schneider Wallstent Endoprosthesis Clinical Investigators. A randomized trial of carotid stenting vs. endarterectomy in patients with symptomatic carotid stenosis: study design. J Neurovasc Dis. 1997;2:228–34.Google Scholar
  34. 34.
    Theron JG, Payelle GG, Coskun O, Huet HF, Guimaraens L. Carotid artery stenosis: treatment with protected balloon angioplasty and stent placement. Radiology. 1996;201:627–36.CrossRefGoogle Scholar
  35. 35.
    Reimers B, Corvaja N, Moshiri S, Sacca S, Albiero R, Di Mario C, Pascotto P, Colombo A. Cerebral protection with filter devices during carotid artery stenting. Circulation. 2001;104:12–5.CrossRefGoogle Scholar
  36. 36.
    Bosiers M, de Donato G, Deloose K, Verbist J, Peeters P, Castriota F, Cremonesi A, Setacci C. Does free cell area influence the outcome in carotid artery stenting? Eur J Vasc Endovasc Surg. 2007;33:135–41. discussion 142-133.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Vernard S. Fennell
    • 1
    • 2
    Email author
  • Sabareesh K. Natarajan
    • 3
  • Adnan H. Siddiqui
    • 4
  1. 1.Department of NeurosurgeryJacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffaloUSA
  2. 2.Gates Vascular Institute at Kaleida HealthBuffaloUSA
  3. 3.Department of NeurosurgeryUniversity at Buffalo, State University of New YorkBuffaloUSA
  4. 4.Departments of Neurosurgery and RadiologyJacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffaloUSA

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