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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.
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 ...
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 ...
The effectiveness of carotid endarterectomy or carotid artery stenting in reducing stroke risk in people with intra-cranial carotid artery stenosis is unknown. [21] In carotid endarterectomy, a surgeon makes an incision in the neck, opens up the carotid artery, and removes the plaque occluding the blood vessel.
Atherosclerotic plaque from a carotid endarterectomy specimen. An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of stroke when the carotid artery is severely narrowed, particularly after a stroke to reduce the risk of additional strokes. [citation needed]
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 ...
Operative Techniques in General Surgery 2007 Dec;(9)4:152-159; McPhee JT, Hill JS, Ciocca RG, Messina LM, Eslami MH (December 2007). "Carotid endarterectomy was performed with lower stroke and death rates than carotid artery stenting in the United States in 2003 and 2004". J. Vasc. Surg. 46 (6): 1112– 1118. doi: 10.1016/j.jvs.2007.08.030 ...
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]