Endarterectomy is usually the treatment of choice in patients presenting with transient ischemic attack and significant atheromatous disease in the region of the carotid bifurcation [1] . Treatment options are less certain in patients with disease distal to that part of the internal carotid artery that is surgically accessible. Symptomatic patients for whom medical therapy is inadequate may req...

Spontaneous bilateral cerebellar infarction in the territory of the superior cerebellar arteries is extremely rare. Occasionally there have been reports of bilateral cerebellar infarction due to vertebrobasilar atherosclerotic occlusion or stenosis, whereas no report of bilateral cerebellar infarction due to complicated hemodynamic changes. In this report, we present a patient with bilateral ce...

BACKGROUND AND PURPOSE The purposes of this study were to assess the relationships between anatomic and technical factors and the 30-day risk of stroke or death after carotid angioplasty and stenting in the Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial and to perform a systematic review of the literature. METHODS We included patients from E...

In this issue of the AJNR, Theron et al. [1] report on a retrospective analysis of carotid angioplasty in 13 patients in whom a modification of a previously described catheter system designed to protect the cerebral circulation during the procedure was used. The temporary arrest of flow within the internal carotid artery and flushing of the arterial segment proximal to the temporary occlusion b...

Key points † Carotid endarterectomy is a standard intervention for carotid artery stenosis, while angioplasty/stenting is gaining acceptance. † General and regional anaesthetic techniques are equally effective for CEA; CAS is performed under sedation. † It is important to optimize cerebral blood flow and minimize myocardial stress during these procedures. Summary. Several multicentre, randomize...

Carotid Angioplasty and Stenting To the Editor: We read with interest the article by Qureshi,1 about carotid angioplasty and stenting (CAS) after the EVA3S trial.2 The author considers that the results of EVA3S are somewhat contradictory to the existing data derived from other studies. To reach this conclusion, Dr Qureshi put together studies that are hardly comparable because of their design (...

Background The major morbidity of percutaneous transluminal coronary angioplasty is acute thrombosis and restenosis of the dilated lesion. Platelet-thrombus deposition occurs within minutes after injury, is primarily mediated by thrombin, causes acute occlusion, and contributes to late restenosis. Experimentally, specific thrombin inhibitors have prevented mural thrombosis. However, local thera...

So far, angioplasty with stenting of the carotid arteries does not seem to offer any clear advantage over traditional carotid endarterectomy for patients with symptomatic or asymptomatic stenosis. This paper reviews recent and ongoing studies of carotid revascularization, with conclusions on how these treatments should be used, based on what we know now.

PURPOSE To review patients who have presented with acute strokes from a middle cerebral artery occlusion in whom in addition to the middle cerebral artery thromboembolus, an internal carotid artery occlusion has been present, and in whom angioplasty of these totally occluded internal carotid arteries has bee n successful. METHODS We reviewed retrospectively our experience in treating a cute s...

The hypothesis that saphenous vein patch angioplasty protects against early postoperative restenosis and thrombosis-occlusion was tested by comparing the clinical outcome and carotid artery status of 100 carotid endarterectomies with and 100 without saphenous vein patch angioplasty performed by a single surgeon over a 30-month period. The patient population, selection, perioperative management,...