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Carotid and Vertebral Intervention

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Peripheral and Cerebrovascular Intervention

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Stroke represents the third most common cause of death in the United States, and nearly 20% of strokes are caused by atherosclerotic carotid artery stenosis. During the past two decades, significant advances in medical therapy and prevention, surgical revascularization, and endovascular treatment options have revolutionized the approach to the management of patients with cerebrovascular disease. Through careful review of the clinical trials literature – both historical and contemporary – we explore areas of controversy and those where consensus exists, enabling the identification of “best practice,” tailored to suit the individual patient and clinical scenario.

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References

  1. Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121(7):e46–e215.

    Article  PubMed  Google Scholar 

  2. Lloyd-Jones D, Adams RJ, Carnethon M, et al. Heart Disease and Stroke Statistics—2009 Update; A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119: e21–e181.

    Article  PubMed  Google Scholar 

  3. Bates ER, Babb JD, Casey DE Jr, et al. ACCF/SCAI/SVMB/SIR/ASITN 2007 clinical expert consensus document on carotid stenting: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (ACCF/SCAI/SVMB/SIR/ASITN Clinical Expert Consensus Document Committee on Carotid Stenting). J Am Coll Cardiol. 2007;49:126–170.

    Article  PubMed  Google Scholar 

  4. Goldstein LB, Adams R, Alberts MJ, et al. Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2006;113:e873–e923.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  Google Scholar 

  6. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995;273:1421–1428.

    Article  Google Scholar 

  7. Debakey ME, Crawford ES, Cooley DA, Morris GC Jr, Garret HE, Fields WS. Cerebral arterial insufficiency: one to 11-year results following arterial reconstructive operation. Ann Surg. 1965;161:921–945.

    Article  PubMed  CAS  Google Scholar 

  8. Thacker EL, Wiggins KL, Rice KM, et al. Short-term and long-term risk of incident ischemic stroke after transient ischemic attack. Stroke. 2010;41(2):239–243.

    Article  PubMed  Google Scholar 

  9. Rothwell PM, Eliasziw M, Gutnikov SA, et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet. 2003;361:107–116.

    Article  PubMed  CAS  Google Scholar 

  10. 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;351:1379–1387.

    Article  Google Scholar 

  11. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342:145–153.

    Article  PubMed  CAS  Google Scholar 

  12. Amarenco P, Bogousslavsky J, Callahan A 3 rd, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006;355:549–559.

    Article  PubMed  CAS  Google Scholar 

  13. Everett BM, Glynn RJ, MacFadyen JG, Ridker PM. Rosuvastatin in the prevention of stroke among men and women with elevated levels of C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER). Circulation;121:143–150.

    Google Scholar 

  14. Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006;37:577–617.

    Article  PubMed  Google Scholar 

  15. Biller J, Feinberg WM, Castaldo JE, et al. Guidelines for carotid endarterectomy: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1998;29:554–562.

    Article  PubMed  CAS  Google Scholar 

  16. Wennberg DE, Lucas FL, Birkmeyer JD, Bredenberg CE, Fisher ES. Variation in carotid endarterectomy mortality in the Medicare population: trial hospitals, volume, and patient characteristics. JAMA. 1998;279:1278–1281.

    Article  PubMed  CAS  Google Scholar 

  17. Rosenfield K. Carotid and Cerebrovascular Disease. In Cath SAP 3, ed. Moliterno DJ, section editor Mukherjee D. Washington DC: American College of Cardiology Foundation; 2008: 1012–1019.

    Google Scholar 

  18. Halliday A, Mansfield A, Marro J, et al. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet. 2004;363:1491–1502.

    Article  PubMed  CAS  Google Scholar 

  19. Kerber CW, Cromwell LD, Loehden OL. Catheter dilatation of proximal carotid stenosis during distal bifurcation endarterectomy. AJNR Am J Neuroradiol. 1980;1:348–349.

    PubMed  CAS  Google Scholar 

  20. Garg N, Karagiorgos N, Pisimisis GT, et al. Cerebral protection devices reduce periprocedural strokes during carotid angioplasty and stenting: a systematic review of the current literature. J Endovasc Ther. 2009;16:412–427.

    Article  PubMed  Google Scholar 

  21. Chaturvedi S, Bruno A, Feasby T, et al. Carotid endarterectomy—an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65:794–801.

    Article  PubMed  CAS  Google Scholar 

  22. Roubin GS, New G, Iyer SS, et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation. 2001;103:532–537.

    PubMed  CAS  Google Scholar 

  23. 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.

    Google Scholar 

  24. Yadav JS, Wholey MH, Kuntz RE, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–1501.

    Article  PubMed  CAS  Google Scholar 

  25. Gurm HS, Yadav JS, Fayad P, et al. Long-term results of carotid stenting versus endarterectomy in high-risk patients. N Engl J Med. 2008;358:1572–1579.

    Article  PubMed  CAS  Google Scholar 

  26. Gray WA, Hopkins LN, Yadav S, et al. Protected carotid stenting in high-surgical-risk patients: the ARCHeR results. J Vasc Surg. 2006;44:258–268.

    Article  PubMed  Google Scholar 

  27. Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–1671.

    Article  PubMed  CAS  Google Scholar 

  28. Ringleb PA, Allenberg J, Bruckmann H, et al. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet. 2006;368:1239–1247.

    Article  PubMed  CAS  Google Scholar 

  29. Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol. 2008;7:893–902.

    Article  PubMed  Google Scholar 

  30. Ederle J, Dobson J, Featherstone RL, et al. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet. 2010;375:985–997.

    Article  PubMed  Google Scholar 

  31. Bonati LH, Dobson J, Algra A, et al. Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis: a preplanned meta-analysis of individual patient data. Lancet. 2010;376:1062–1073.

    Article  PubMed  Google Scholar 

  32. Brott TG, Hobson RW 2nd, Howard G, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11–23.

    Article  PubMed  CAS  Google Scholar 

  33. Landesberg G, Shatz V, Akopnik I, et al. Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery. J Am Coll Cardiol. 2003;42:1547–1554.

    Article  PubMed  CAS  Google Scholar 

  34. Kertai MD, Boersma E, Klein J, Van Urk H, Bax JJ, Poldermans D. Long-term prognostic value of asymptomatic cardiac troponin T elevations in patients after major vascular surgery. Eur J Vasc Endovasc Surg. 2004;28:59–66.

    Article  PubMed  CAS  Google Scholar 

  35. Safian RD, Bresnahan JF, Jaff MR, et al. Protected carotid stenting in high-risk patients with severe carotid artery stenosis. J Am Coll Cardiol. 2006;47:2384–2389.

    Article  PubMed  Google Scholar 

  36. Ansel GM, Hopkins LN, Jaff MR, et al. Safety and effectiveness of the INVATEC MO.MA proximal cerebral protection device during carotid artery stenting: results from the ARMOUR pivotal trial. Catheter Cardiovasc Interv. 2010;76:1–8.

    Article  PubMed  Google Scholar 

  37. Gray WA, Chaturvedi S, Verta P. Thirty-day outcomes for carotid artery stenting in 6320 patients from 2 prospective, multicenter, high-surgical-risk registries. Circ Cardiovasc Interv. 2009;2:159–166.

    Article  PubMed  Google Scholar 

  38. Grant A, White C, Ansel G, Bacharach M, Metzger C, Velez C. Safety and efficacy of carotid stenting in the very elderly. Catheter Cardiovasc Interv. 2010;75:651–655.

    Article  PubMed  Google Scholar 

  39. Uflacker R. Atlas of Vascular Anatomy: An Angiographic Approach. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2007.

    Google Scholar 

  40. Atkins MD, Bush RL. Embolic protection devices for carotid artery stenting: have they made a significant difference in outcomes? Semin Vasc Surg. 2007;20:244–251.

    Article  PubMed  Google Scholar 

  41. Caplan LR, Wityk RJ, Glass TA, et al. New England Medical Center Posterior Circulation Registry. Ann Neurol. 2004;56:389–398.

    Article  PubMed  Google Scholar 

  42. Savitz SI, Caplan LR. Vertebrobasilar disease. N Engl J Med. 2005;352:2618–2626.

    Article  PubMed  CAS  Google Scholar 

  43. Mukherjee D, Rosenfield K. Manual of Peripheral Vascular Interventions. Philadelphia: Lippincott, Williams & Wilkins; 2005.

    Google Scholar 

  44. Cloud GC, Markus HS. Diagnosis and management of vertebral artery stenosis. QJM. 2003;96:27–54.

    Article  PubMed  CAS  Google Scholar 

  45. Imparato AM. Vertebral arterial reconstruction: a nineteen-year experience. J Vasc Surg. 1985;2:626–634.

    PubMed  CAS  Google Scholar 

  46. Thevenet A, Ruotolo C. Surgical repair of vertebral artery stenoses. J Cardiovasc Surg. 1984;25:101–110.

    CAS  Google Scholar 

  47. Sivenius J, Riekkinen PJ, Smets P, Laakso M, Lowenthal A. The European Stroke Prevention Study (ESPS): results by arterial distribution. Ann Neurol. 1991;29:596–600.

    Article  PubMed  CAS  Google Scholar 

  48. Jenkins JS, Patel SN, White CJ, et al. Endovascular stenting for vertebral artery stenosis. J Am Coll Cardiol;55:538–542.

    Google Scholar 

  49. Sundt TM Jr, Smith HC, Campbell JK, Vlietstra RE, Cucchiara RF, Stanson AW. Transluminal angioplasty for basilar artery stenosis. Mayo Clin Proc. 1980;55:673–680.

    PubMed  Google Scholar 

  50. Mukherjee D, Roffi M, Kapadia SR, et al. Percutaneous intervention for symptomatic vertebral artery stenosis using coronary stents. J Invasive Cardiol. 2001;13:363–366.

    PubMed  CAS  Google Scholar 

  51. Malek AM, Higashida RT, Phatouros CC, et al. Treatment of posterior circulation ischemia with extracranial percutaneous balloon angioplasty and stent placement. Stroke. 1999;30:2073–2085.

    Article  PubMed  CAS  Google Scholar 

  52. Jenkins JS, White CJ, Ramee SR, et al. Vertebral artery stenting. Catheter Cardiovasc Interv. 2001;54:1–5.

    Article  PubMed  CAS  Google Scholar 

  53. Chastain HD 2nd, Campbell MS, Iyer S, et al. Extracranial vertebral artery stent placement: in-hospital and follow-up results. J Neurosurg. 1999;91:547–552.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Douglas E. Drachman MD

  2. Structural Heart Disease and Non-Coronary Interventions, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Nicholas J. Ruggiero II MD

  3. Vascular Medicine and Intervention, Department of Cardiology, Massachusetts General Hospital, Boston, MA, USA

    Kenneth Rosenfield MD

Authors
  1. Douglas E. Drachman MD
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  2. Nicholas J. Ruggiero II MD
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  3. Kenneth Rosenfield MD
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Corresponding author

Correspondence to Douglas E. Drachman MD .

Editor information

Editors and Affiliations

  1. and Women’s Hospital, and Harvard Medica, Department of Cardiovascular Medicine, VA Boston Healthcare System, Brigham, Francis Street 75, Boston, 02115, Massachusetts, USA

    Deepak L. Bhatt

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Drachman, D.E., Ruggiero, N.J., Rosenfield, K. (2012). Carotid and Vertebral Intervention. In: Bhatt, D. (eds) Peripheral and Cerebrovascular Intervention. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-60327-965-9_6

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  • DOI: https://doi.org/10.1007/978-1-60327-965-9_6

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-964-2

  • Online ISBN: 978-1-60327-965-9

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