BACKGROUND AND PURPOSE Carotid revascularization procedures can be complicated by stroke. Additional disability adds to the already high costs of the procedure. To weigh the cost and benefit, we estimated the cost-utility of carotid angioplasty and stenting compared with carotid endarterectomy among patients with symptomatic carotid stenosis, with special emphasis on scenario analyses that woul...

Carotid intervention for the amelioration of symptoms due to carotid stenosis has been a controversial therapeutic concept for much of its history. Operative carotid surgery (carotid endarterectomy) underwent considerable turmoil and challenge during the late 20th century, eventually becoming a generally accepted approach in the management of symptomatic critical carotid artery stenosis. A simi...

Carotid angioplasty and stenting has recently emerged as a popular alternative to endarterectomy for the treatment of carotid atherosclerosis. Carotid endarterectomy has been scientifically validated, but many believe carotid angioplasty and stenting to be a less invasive, less expensive and equally safe and effective method of treatment. The evidence for and against the use of each procedure w...

BACKGROUND Carotid percutaneous transluminal angioplasty may be a useful non-surgical procedure for carotid stenosis, particularly for lesions not suitable for surgery. OBJECTIVES The objective of this review was to assess the effect of carotid percutaneous transluminal angioplasty compared with carotid endarterectomy (in patients suitable for surgery) or medical therapy (in patients not suit...

BACKGROUND AND PURPOSE Cerebral hyperperfusion syndrome has been increasingly reported as a complication of carotid angioplasty and stent placement. The aim of the present study was to determine significant predictors of hyperperfusion phenomenon after carotid angioplasty and stent placement. METHODS We retrospectively reviewed 30 consecutive patients with unilateral severe carotid stenosis w...

OBJECTIVE As the mortality associated with coronary artery bypass grafts has fallen, morbidity has become an increasing problem. The improvement of transluminal carotid angioplasty is enlarged to patients with asymptomatic severe carotid stenosis (> 85%) requiring coronary surgery. METHODS Between January 1993 and January 1995, 10 patients underwent percutaneous carotid angioplasty prior to c...

Background and Purpose Carotid angioplasty may offer an effective treatment for carotid stenosis, but there has been concern about the incidence and clinical consequences of distal embolization. Transcranial Doppler monitoring in carotid endarterectomy has demonstrated embolic signals during this procedure. We used this technique in patients undergoing carotid angioplasty. Methods Transcranial ...

Extracranial carotid stenosis is a known complication of external irradiation to the head and neck region. We report on a patient with previous carotid endarterectomy for irradiation-associated carotid stenosis. This patient developed symptomatic carotid stenosis over the ipsilateral common carotid artery proximal to the previous endarterectomy site 3 years later, and was successfully treated w...

Hyperperfusion syndrome is a well-documented complication of carotid endarterectomy, as well as internal carotid artery angioplasty and stent placement. We report a similar complication after distal intracranial (middle cerebral artery [MCA] M2 segment) angioplasty. To our knowledge, this is the first report of hyperperfusion syndrome after intracranial angioplasty of a distal MCA branch.

The rationale for carotid revascularization, surgical or interventional, is to reduce the patient’s future risk of stroke. Unfortunately, carotid revascularization itself poses a risk of stroke, and enormous efforts have been made in refining both surgical and interventional techniques to reduce periprocedural stroke risk. The incidence of stroke during carotid endarterectomy (CEA) has been red...