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Current Management of Extracranial Carotid Artery Disease

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY, plf2001{at}med.cornell.edu

Rabih A. Chaer, MD

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY

Sheela Patel, MD

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY

Stephanie C. Lin, MD

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY

Brian DeRubertis, MD

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY

K. Craig Kent, MD

Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, Weill Medical College and Columbia University, College of Physicians and Surgeons, New York, NY

Stroke is the third most common cause of death in the United States. There are approximately 700,000 strokes/year; 80% are ischemic, and 20-30% of ischemic strokes are secondary to carotid disease. Carotid stenosis is traditionally treated by carotid endarterectomy (CEA). Multicenter, randomized, controlled trials have shown that surgery significantly reduces the risk of ipsilateral stroke in patients with severe symptomatic and asymptomatic carotid stenosis. Endovascular techniques for treating carotid stenosis have been developed over recent years. Carotid angioplasty and stenting (CAS) with cerebral protection has become an alternative to CEA for high-surgical-risk patients and the procedure of choice for stenoses inaccessible by surgery. In this review we summarize the existing data regarding the traditional state of management of extracranial carotid artery stenosis and compare these data to a critical analysis of the recent results of CAS.

Vascular and Endovascular Surgery, Vol. 40, No. 3, 165-175 (2006)
DOI: 10.1177/153857440604000301


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