33 Endovascular Stenting in Atherosclerotic Carotid Artery Stenosis

Chandra Krishna, Evelyn L. Turcotte, Devi P. Patra, Mathew E. Welz, Stefan W. Koester, and Bernard R. Bendok

Abstract

Carotid artery stenosis refers to the luminal narrowing of the carotid artery due to atherosclerotic plaque buildup. The pathogenesis is consistent with that of atherosclerotic disease elsewhere, in which luminal damage is followed by the accumulation of fatty deposits and cholesterol at the site of damage. The primary goal of carotid stenosis treatment is to prevent the occurrence of stroke and stroke-related symptoms. The treatment of carotid stenosis may include medical management alone, or medical management in combination with either carotid endarterectomy (CEA), or carotid artery stenting (CAS). Utilizing a revascularization technique, whether CEA or CAS, requires a comprehensive assessment of clinical presentation, anatomical location and characteristics of the lesion, risk of stroke, and patient preference. In this chapter, indications are presented for treating carotid artery stenosis with CAS and angioplasty, and an overview is given of the pathogenesis, diagnostic modalities, and treatment options.

Key words

carotid artery stenosis - carotid artery stenting - carotid endarterectomy - endovascular revascularization - carotid angioplasty

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