Authors' objectives:

The aim of this report is to assess the use of carotid, vertebral and intracranial artery angioplasty and stenting.

Authors' recommendations: With regard to carotid, vertebral, and intracranial angioplasty and stenting the ICSI Technology Assessment Committee finds the following: 1. Carotid angioplasty and stenting (CAS), especially when using an embolic protection device, is a relatively safe procedure when performed by providers experienced with the technology. 2. A number of short-term studies have shown CAS to be generally equivalent to carotid endarterectomy (the reference standard) in safety and efficacy, especially in populations at increased risk for surgery (i.e., SAPPHIRE trial). However, lack of longer-term follow-up does not permit conclusions regarding CAS in terms of long-term (greater than 1 year) efficacy. Results of ongoing randomized trials may provide further clarity in this area. (Conclusion Grade III) 3. The evidence is scant concerning the efficacy of vertebral and intracranial angioplasty and stenting. Thus, no conclusions can be drawn about the efficacy of these procedures. In addition, vertebral and intracranial artery angioplasty and stenting is technically difficult and carries a high risk of complications, up to 20% in some studies.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.icsi.org/knowledge/detail.asp?catID=107&itemID=2482

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical Systems Improvement

Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675

Contact Name: icsi.info@icsi.org

Contact Email: icsi.info@icsi.org

Copyright: Institute for Clinical Systems Improvement (ICSI)