Abstract
Strokes are the third leading cause of death in the United States. Carotid artery occlusive disease accounts for about 20% to 30% of all strokes. Carotid endarterectomy has been the traditional standard treatment for patients with significant carotid artery disease. However, surgical therapy is associated with significant complications. Carotid angioplasty and stenting offers an attractive alternative to surgery. There have been significant advances in this field including the use of embolic protection devices. In this article, we review the current literature addressing the role of endovascular interventions in the management of patients with significant carotid stenosis.
There are approximately 700,000 new cases of stroke in the United States each year, leading to significant morbidity and mortality. Stroke is the third leading cause of death in the country. 1 Carotid artery occlusive disease accounts for 20% to 30% of all strokes. 2 Carotid endarterectomy (CEA) has been the traditional standard therapy for symptomatic and asymptomatic patients with significant stenosis. 3-5 Although surgical therapy improves outcome in these patients, it is an operative procedure that can be associated with significant morbidity and mortality. Recently, carotid artery angioplasty and stenting (CAS) has emerged as a promising, less invasive alternative for certain subsets of patients with carotid stenosis.