Stent angioplasty in the treatment of carotid stenosis
De Luca M, Pichon Riviere A
Record ID 32005000614
This report evaluates the effectiveness of stent angioplasty in the treatment of carotid stenosis
Authors' results and conclusions: Endovascular procedures (EVP) such as percutaneous transluminal angioplasty (PTA) and stent placement (S) could present lower risks and costs. Consequently, they are an alternative to carotid stenosis or in patients with contraindications to it. However, currently there is evidence against with respect to EVP safety, and its long-term efficacy is uncertain. Even in patients where the standard surgical procedure is contraindicated, there has not been any study that compares its benefits with those of the conventional medical treatment. That is why, its use cannot be recommended beyond the scope of strictly controlled experimental research.There are special situations, e.g. post-endarterectomy recurrent stenosis, surgical access impossibility and post-radiation stenosis which are difficult to evaluate in randomized controlled trials today, so it is not possible to make any recommendation. These situations should be carefully evaluated according to the audit, consensus, qualified professional experience and expressly defined preference criteria.As with carotid endarterectomy, EVP requires an adequate learning curve, certification, training and experience.
Authors' recomendations: Results from strictly designed, randomized multicenter trials that evaluate improvements in techniques and in particular, the use of brain protecting devices are still expected. In turn, they will study higher surgical risk subgroups. The role of the recently introduced pharmacological adjuvant therapy (e.g. abixcimab or S-nitrosoglutathione) is still uncertain.Until these trials show conclusive results, endovascular procedures cannot be recommended in a generalized way.
Authors' methods: Overview
Project Status: Completed
URL for project: http://www.iecs.org.ar/
Year Published: 2003
English language abstract: An English language summary is available
Publication Type: Not Assigned
- Angioplasty, Balloon
- Carotid Stenosis
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: email@example.com
Contact Email: firstname.lastname@example.org
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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