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Carotid artery stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky.
Cerebral hyperperfusion syndrome, also known as reperfusion syndrome, is a dysregulated state of cerebral blood flow following the restoration of arterial blood flow to the brain, usually following treatment of carotid artery stenosis. [1]
All interventions for carotid revascularization (carotid endarterectomy, carotid stenting, and transcarotid artery revascularization) carry some risk of stroke; however, where the risk of stroke over time from medical management alone is high, intervention may be beneficial. Carotid artery stenting and carotid endarterectomy have been found to ...
Screening for carotid artery narrowing has not been shown to be a useful test in the general population. [143] Studies of surgical intervention for carotid artery stenosis without symptoms have shown only a small decrease in the risk of stroke. [144] [145] To be beneficial, the complication rate of the surgery should be kept below 4%. Even then ...
The carotid artery is the large vertical artery in red. The blood supply to the common carotid artery starts at the arch of the aorta (left) or the subclavian artery (right). The common carotid artery divides into the internal carotid artery and the external carotid artery. Plaque often builds up at that division, and a carotid endarterectomy ...
The resulting watershed infarcts in carotid artery blockages have mostly been considered to be due to a reduced blood flow, similar to that of hypotension. [2] Imaging studies in severe internal carotid artery (ICA) disease report an incidence of watershed stroke ranging from 19% to 64%. [3]
The goal of treatment is to prevent the development of an actual stroke or limit the continuation of neurologic deficits should a stroke occur after dissection. Treatments include observation, anti-platelet agents, anticoagulation, stent implantation, carotid endarterectomy, and carotid artery ligation. [10] [32]
Cerebral Hyperperfusion Syndrome leading to stroke is a serious complication of carotid artery angioplasty with stenting. [27] Angioplasty may also provide a less durable treatment for atherosclerosis and be more prone to restenosis relative to vascular bypass or coronary artery bypass grafting. [28]
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