Subscribe to RSS
DOI: 10.1055/a-1952-1159
Carotid Stenosis and Stroke: Medicines, Stents, Surgery—“Wait-and-See” or Protect?
Funding This study was supported by a research grant from the Jagiellonian University Medical College (K/ZDS/007819), Polish Cardiac Society/Servier Clinical Research in Atherosclerosis Grant, and Polish Cardiac Society/ADAMED Basic Research in Atherosclerosis Grant (to P.M.). Open access publication was funded by the Priority Research Area qLife under the program “Excellence Initiative — Research University” at the Jagiellonian University in Krakow (No. 06/IDUB/2019/94).Carotid Stenosis and Stroke Mechanisms
Stroke, a vascular disease of the brain, is the most common cause of complex disability and a major cause of death worldwide.[1] [2] [3] Stroke, with its major negative impact on affected individuals, their families, and the society, is one of the most dreaded events in life.[4] Nearly half of stroke survivors will be disabled and dependent, with one in seven requiring permanent institutional care.[4] Because of the profound negative effect of stroke-related mental and physical disabilities upon quality of life, a significant proportion of stroke victims indicate that they would have preferred death over their life after stroke.[4] Only a minority of strokes are preceded by a transient ischemic attack (TIA), a warning that enables timely intervention to reduce the risk of permanent brain damage.[5] [6] Over 80% of strokes occur without any clinical warning.[6] Hence there is a fundamental role for effective preventive measures.[6] [7] [8] Optimal stroke management should be preventive rather than reactive to the devastating event that has already occurred.[5] [7] [8] Despite unquestionable progress in pharmacologic and nonpharmacologic prevention, the burden of cardiovascular disease (including stroke) will not be decreasing—but rather increasing—over the next 25 years.[1] Recent stroke burden estimates for Europe indicate an increase in stroke incidence of +3% by 2047, and an increase by ≈30%% of the number of people living with stroke.[9]
Atherosclerotic carotid artery stenosis is a modifiable, major mechanistic risk factor of ischemic stroke.[2] [10] Plaque rupture and/or erosion can lead to focal thrombus formation that may occlude the lumen, causing a stroke related to hemodynamic compromise.[10] [11] [12] [13] [14] Thrombotic occlusion of the internal carotid artery is poorly responsible to intravenous thrombolysis and is associated with large infarct size and poor functional outcome.[14] [15] [16] [17] Another stroke mechanism is atherothromboembolism to the brain, resulting in occlusion of an intracranial branch vessel(s) and infarction of the brain tissue supplied by these branches.[12] [18] Real-life contemporary scenarios of acute ischemic stroke due to atherothrombotic carotid stenosis are demonstrated in [Fig. 1] (all patients presenting with acute stroke of carotid origin within one month).
Publication History
Received: 11 November 2021
Accepted: 27 September 2022
Accepted Manuscript online:
28 September 2022
Article published online:
10 July 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Pearson J, Sipido KR, Musialek P, van Gilst WH. The Cardiovascular Research community calls for action to address the growing burden of cardiovascular disease. Cardiovasc Res 2019; 115 (10) e96-e98
- 2 Mozaffarian D, Benjamin EJ, Go AS. et al; Writing Group Members, American Heart Association Statistics Committee, Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2016; 133 (04) e38-e360
- 3 Adamson J, Beswick A, Ebrahim S. Is stroke the most common cause of disability?. J Stroke Cerebrovasc Dis 2004; 13 (04) 171-177
- 4 Sturm JW, Donnan GA, Dewey HM. et al. Quality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2004; 35 (10) 2340-2345
- 5 Musiałek P, Grunwald IQ. How asymptomatic is “asymptomatic” carotid stenosis? Resolving fundamental confusion(s) - and confusions yet to be resolved. Pol Arch Intern Med 2017; 127 (11) 718-719
- 6 Hackam DG, Kapral MK, Wang JT, Fang J, Hachinski V. Most stroke patients do not get a warning: a population-based cohort study. Neurology 2009; 73 (13) 1074-1076
- 7 Paraskevas KI, Eckstein HH, Mikhailidis DP, Veith FJ, Spence JD. Rationale for screening selected patients for asymptomatic carotid artery stenosis. Curr Med Res Opin 2020; 36 (03) 361-365
- 8 Musialek P, Hopf-Jensen S. Carotid artery revascularization for stroke prevention: a new era. J Endovasc Ther 2017; 24 (01) 138-148
- 9 Wafa HA, Wolfe CDA, Emmett E, Roth GA, Johnson CO, Wang Y. Burden of stroke in Europe: thirty-year projections of incidence, prevalence, deaths, and disability-adjusted life years. Stroke 2020; 51 (08) 2418-2427
- 10 Spagnoli LG, Mauriello A, Sangiorgi G. et al. Extracranial thrombotically active carotid plaque as a risk factor for ischemic stroke. JAMA 2004; 292 (15) 1845-1852
- 11 Sakakura K, Nakano M, Otsuka F, Ladich E, Kolodgie FD, Virmani R. Pathophysiology of atherosclerosis plaque progression. Heart Lung Circ 2013; 22 (06) 399-411
- 12 Powers WJ, Rabinstein AA, Ackerson T. et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019; 50 (12) e344-e418
- 13 Ni H, Zhou C, Hang Y. et al. Endovascular treatment for acute ischaemic stroke caused by isolated internal carotid artery occlusion: treatment strategies, outcomes, and prognostic factors. Clin Radiol 2023; 78 (06) 451-458
- 14 Yeo LLL, Kong WY, Paliwal P. et al. Intravenous Thrombolysis for Acute Ischemic Stroke due to Cervical Internal Carotid Artery Occlusion. J Stroke Cerebrovasc Dis 2016; 25 (10) 2423-2429
- 15 Saqqur M, Uchino K, Demchuk AM. et al; CLOTBUST Investigators. Site of arterial occlusion identified by transcranial Doppler predicts the response to intravenous thrombolysis for stroke. Stroke 2007; 38 (03) 948-954
- 16 Bhatia R, Hill MD, Shobha N. et al. Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action. Stroke 2010; 41 (10) 2254-2258
- 17 Koga M, Arihiro S, Miyashita F. et al. Factors associated with early recanalization failure following intravenous rt-PA therapy for ischemic stroke. Cerebrovasc Dis 2013; 36 (04) 299-305
- 18 Rubiera M, Ribo M, Delgado-Mederos R. et al. Tandem internal carotid artery/middle cerebral artery occlusion: an independent predictor of poor outcome after systemic thrombolysis. Stroke 2006; 37 (09) 2301-2305
- 19 Podlasek A, Grunwald IQ, Musiałek P. The evolution from an “average” study patient to patient-specific characteristics to guide interventions in vascular medicine. Pol Arch Intern Med 2021; 131 (01) 5-8
- 20 Musialek P, Bonati LH, Bulbulia R. et al. Stroke risk management in carotid atherosclerotic disease: A Clinical Consensus Statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases. Cardiovasc Res 2023; (e-pub ahead of print) DOI: 10.1093/cvr/cvad135.
- 21 Larson A, Nardi V, Brinjikji W, Benson JC, Lanzino G, Savastano L. Endarterectomy for symptomatic non-stenotic carotids: a systematic review and descriptive analysis. Stroke Vasc Neurol 2022; 7 (01) 6-12
- 22 Abbott AL, Bladin CF, Levi CR, Chambers BR. What should we do with asymptomatic carotid stenosis?. Int J Stroke 2007; 2 (01) 27-39
- 23 Abbott AL. Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis. Stroke 2009; 40 (10) e573-e583
- 24 Mizowaki T, Fujita A, Inoue S. et al. Outcome and effect of endovascular treatment in stroke associated with acute extracranial internal carotid artery occlusion: Single-center experience in Japan. J Stroke Cerebrovasc Dis 2020; 29 (07) 104824
- 25 Ospel JM, Marko M, Singh N, Goyal M, Almekhlafi MA. Prevalence of Non-Stenotic (<50%) Carotid Plaques in Acute Ischemic Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis 2020; 29 (10) 105117
- 26 Kopczak A, Schindler A, Bayer-Karpinska A. et al. Complicated Carotid Artery Plaques as a Cause of Cryptogenic Stroke. J Am Coll Cardiol 2020; 76 (19) 2212-2222
- 27 Kamtchum-Tatuene J, Wilman A, Saqqur M, Shuaib A, Jickling GC. Carotid Plaque With High-Risk Features in Embolic Stroke of Undetermined Source: Systematic Review and Meta-Analysis. Stroke 2020; 51 (01) 311-314
- 28 Kopczak A, Schindler A, Sepp D. et al. Complicated Carotid Artery Plaques and Risk of Recurrent Ischemic Stroke or TIA. J Am Coll Cardiol 2022; 79 (22) 2189-2199
- 29 Tekieli L, Mazurek A, Dzierwa K. et al. Misclassification of carotid stenosis severity with area stenosis-based evaluation by computed tomography angiography: impact on erroneous indication to revascularization or patient (lesion) migration to a higher guideline recommendation class as per ESC/ESVS/ESO/SVS and CMS-FDA thresholds. Adv Interv Cardiol 2022; 18 (04) 500-513
- 30 Tekieli L, Kablak-Ziembicka A, Dabrowski W. et al. Imaging modality-dependent carotid stenosis severity variations against intravascular ultrasound as a reference: Carotid Artery intravasculaR Ultrasound Study (CARUS). Int J Cardiovasc Imaging 2023; 39 (10) 1909-1920
- 31 de Weerd M, Greving JP, de Jong AW, Buskens E, Bots ML. Prevalence of asymptomatic carotid artery stenosis according to age and sex: systematic review and metaregression analysis. Stroke 2009; 40 (04) 1105-1113
- 32 Petrova M, Kiat H, Gavino A, McLachlan CS. Carotid ultrasound screening programs in rural communities: a systematic review. J Pers Med 2021; 11 (09) 897
- 33 Porcu M, Mannelli L, Melis M. et al. Carotid plaque imaging profiling in subjects with risk factors (diabetes and hypertension). Cardiovasc Diagn Ther 2020; 10 (04) 1005-1018
- 34 Redgrave JN, Lovett JK, Syed AB, Rothwell PM. Histological features of symptomatic carotid plaques in patients with impaired glucose tolerance and diabetes (oxford plaque study). Cerebrovasc Dis 2008; 26 (01) 79-86
- 35 Sarwar N, Gao P, Seshasai SR. et al; Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375 (9733): 2215-2222
- 36 Wei LM, Zhu YQ, Bao YQ. et al. Atherosclerosis in intracranial or extracranial vessels in diabetic patients and the association with stroke subtype. Quant Imaging Med Surg 2019; 9 (06) 960-967
- 37 Mazurek A, Borratynska A, Gancarczyk U. et al. Diabetes Mellitus and Clinical Outcomes in Carotid Artery Revascularization Using Second-Generation, MicroNet-Covered Stents: Analysis from the PARADIGM Study. J Diabetes Res 2022; 2022: 8691842
- 38 Conrad MF, Michalczyk MJ, Opalacz A, Patel VI, LaMuraglia GM, Cambria RP. The natural history of asymptomatic severe carotid artery stenosis. J Vasc Surg 2014; 60 (05) 1218-1226
- 39 Paraskevas KI, Nicolaides AN, Kakkos SK. Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study: what have we learned from it?. Ann Transl Med 2020; 8 (19) 1271
- 40 Conrad MF, Boulom V, Mukhopadhyay S, Garg A, Patel VI, Cambria RP. Progression of asymptomatic carotid stenosis despite optimal medical therapy. J Vasc Surg 2013; 58 (01) 128-35.e1
- 41 Vanassche T, Lauw MN, Eikelboom JW. et al. Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES. Eur Heart J 2015; 36 (05) 281-7a
- 42 Högberg D, Björck M, Mani K, Svensjö S, Wanhainen A. Five year outcomes in men screened for carotid artery stenosis at 65 years of age: a population based cohort study. Eur J Vasc Endovasc Surg 2019; 57 (06) 759-766
- 43 Borissoff JI, Spronk HM, ten Cate H. The hemostatic system as a modulator of atherosclerosis. N Engl J Med 2011; 364 (18) 1746-1760
- 44 Ząbczyk M, Natorska J, Undas A. Fibrin clot properties in atherosclerotic vascular disease: from pathophysiology to clinical outcomes. J Clin Med 2021; 10 (13) 2999
- 45 Loeffen R, Spronk HM, ten Cate H. The impact of blood coagulability on atherosclerosis and cardiovascular disease. J Thromb Haemost 2012; 10 (07) 1207-1216
- 46 Ząbczyk M, Ariëns RAS, Undas A. Fibrin clot properties in cardiovascular disease: from basic mechanisms to clinical practice. Cardiovasc Res 2023; 119 (01) 94-111
- 47 Musiałek P, Monteiro A, Siddiqui AH. Atrial fibrillation and stroke: more than a story of a villain and a victim. Pol Arch Intern Med 2022; 132 (02) 16213
- 48 Khan AA, Patel J, Desikan S. et al. Asymptomatic carotid artery stenosis is associated with cerebral hypoperfusion. J Vasc Surg 2021; 73 (05) 1611-1621.e2
- 49 Grunwald IQ, Papanagiotou P, Reith W. et al. Influence of carotid artery stenting on cognitive function. Neuroradiology 2010; 52 (01) 61-66
- 50 Antonopoulos CN, Kakisis JD, Sfyroeras GS. et al. The impact of carotid artery stenting on cognitive function in patients with extracranial carotid artery stenosis. Ann Vasc Surg 2015; 29 (03) 457-469
- 51 Gaba K, Bulbulia R. Identifying asymptomatic patients at high-risk for stroke. J Cardiovasc Surg (Torino) 2019; 60 (03) 332-344
- 52 Banerjee C, Moon YP, Paik MC. et al. Duration of diabetes and risk of ischemic stroke: the Northern Manhattan Study. Stroke 2012; 43 (05) 1212-1217
- 53 Paraskevas KI, Mikhailidis DP, Veith FJ, Spence JD. Definition of best medical treatment in asymptomatic and symptomatic carotid artery stenosis. Angiology 2016; 67 (05) 411-419
- 54 Paraskevas KI, Mikhailidis DP, Baradaran H. et al. Optimal management of asymptomatic carotid stenosis: counterbalancing the benefits with the potential risks. J Stroke 2022; 24 (01) 163-165
- 55 Ding WY, Rivera-Caravaca JM, Marin F, Torp-Pedersen C, Roldán V, Lip GYH. Prediction of residual stroke risk in anticoagulated patients with atrial fibrillation: mCARS. J Clin Med 2021; 10 (15) 335
- 56 Paraskevas KI, Veith FJ, Ricco JB. Best medical treatment alone may not be adequate for all patients with asymptomatic carotid artery stenosis. J Vasc Surg 2018; 68 (02) 572-575
- 57 Musialek P, Mazurek A, Trystula M. et al. Novel PARADIGM in carotid revascularisation: Prospective evaluation of All-comer peRcutaneous cArotiD revascularisation in symptomatic and Increased-risk asymptomatic carotid artery stenosis using CGuard™ MicroNet-covered embolic prevention stent system. EuroIntervention 2016; 12 (05) e658-e670
- 58 Stabile E, de Donato G, Musialek P. et al. Use of dual-layered stents for carotid artery angioplasty: 1-year results of a patient-based meta-analysis. JACC Cardiovasc Interv 2020; 13 (14) 1709-1715
- 59 Aboyans V, Ricco JB, Bartelink MEL. et al; ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2018; 39 (09) 763-816
- 60 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ 1996; 312 (7023): 71-72
- 61 Ding WY, Rivera-Caravaca JM, Marín F, Li G, Roldán V, Lip GYH. Number needed to treat for net effect of anticoagulation in atrial fibrillation: Real-world vs. clinical-trial evidence. Br J Clin Pharmacol 2022; 88 (01) 282-289
- 62 Brott TG, Halperin JL, Abbara S. et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Developed in collaboration with the American Academy of Neurology and Society of Cardiovascular Computed Tomography. Catheter Cardiovasc Interv 2013; 81 (01) E76-E123
- 63 Kamtchum-Tatuene J, Noubiap JJ, Wilman AH, Saqqur M, Shuaib A, Jickling GC. Prevalence of high-risk plaques and risk of stroke in patients with asymptomatic carotid stenosis: a meta-analysis. JAMA Neurol 2020; 77 (12) 1524-1535
- 64 Nakagawa I, Kotsugi M, Park HS. et al. Near-infrared spectroscopy carotid plaque characteristics and cerebral embolism in carotid artery stenting. EuroIntervention 2021; 17 (07) 599-606
- 65 Musialek P, Dabrowski W, Mazurek A. et al. Quantitative virtual histology for in vivo evaluation of human atherosclerosis—a plaque biomechanics-based novel image analysis algorithm: validation and applications to atherosclerosis research. In: Balocco S. ed. Intravascular Ultrasound: From Acquisition to Advanced Quantitative Analysis. New York, NY: Elsevier; 2020: 71-96
- 66 Liapis CD, Eckstein HH, Paraskevas KI, Cronenwett JL. Emerging evidence suggests that patients with high-grade asymptomatic carotid stenosis should be revascularized. J Vasc Surg 2022; 75 (1S): 23S-25S
- 67 Hosseini AA, Simpson RJ, Altaf N, Bath PM, MacSweeney ST, Auer DP. Magnetic resonance imaging plaque hemorrhage for risk stratification in carotid artery disease with moderate risk under current medical therapy. Stroke 2017; 48 (03) 678-685
- 68 Musialek P, Tracz W, Tekieli L. et al. Multimarker approach in discriminating patients with symptomatic and asymptomatic atherosclerotic carotid artery stenosis. J Clin Neurol 2013; 9 (03) 165-175
- 69 Zhang Y, Bai Y, Xie J. et al. Carotid plaque components and other carotid artery features associated with risk of stroke: A systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2022; 31 (12) 106857
- 70 Högberg D, Mani K, Wanhainen A, Svensjö S. Clinical effect and cost-effectiveness of screening for asymptomatic carotid stenosis: a Markov model. Eur J Vasc Endovasc Surg 2018; 55 (06) 819-827
- 71 Poorthuis MHF, Sherliker P, de Borst GJ. et al. Detection rates of asymptomatic carotid artery stenosis and atrial fibrillation by selective screening of patients without cardiovascular disease. Int J Cardiol 2023; 391: 131262
- 72 Khaleghi M, Isseh IN, Jouni H, Sohn S, Bailey KR, Kullo IJ. Family history as a risk factor for carotid artery stenosis. Stroke 2014; 45 (08) 2252-2256
- 73 Sangiorgi G, Bedogni F, Sganzerla P. et al. The Virtual histology In CaroTids Observational RegistrY (VICTORY) study: a European prospective registry to assess the feasibility and safety of intravascular ultrasound and virtual histology during carotid interventions. Int J Cardiol 2013; 168 (03) 2089-2093
- 74 Kotsugi M, Takayama K, Myouchin K. et al. Carotid artery stenting: investigation of plaque protrusion incidence and prognosis. JACC Cardiovasc Interv 2017; 10 (08) 824-831
- 75 Musialek P, Capoccia L, Alvarez CA. et al. Carotid Artery Endovascular Reconstruction Using Micronet-Covered Stents in Patients with Symptoms or Signs of Cerebral Ischemia (CGuard OPTIMA Trial Investigators; OPtimal sequestration of high-risk carotid lesions with effecTive lumen reconstruction usIng MicroNet–covered stents And the endovascular route, NCT04234854). TCT Featured Research. Available from: https://d18mqtxkrsjgmh.cloudfront.net/public/2022-09/a355a7ab-6d71-44de-8ecf-6712bd763300.pdf [accessed 12 November2023].
- 76 Obeid T, Arnaoutakis DJ, Arhuidese I. et al. Poststent ballooning is associated with increased periprocedural stroke and death rate in carotid artery stenting. J Vasc Surg 2015; 62 (03) 616-23.e1
- 77 Musiałek P, Roubin GS. Double-layer carotid stents: from the clinical need, through a stent-in-stent strategy, to effective plaque isolation… the journey toward safe carotid revascularization using the endovascular route. J Endovasc Ther 2019; 26 (04) 572-577
- 78 Karpenko A, Bugurov S, Ignatenko P. et al. Randomized controlled trial of conventional versus MicroNet-covered stent in carotid artery revascularization. JACC Cardiovasc Interv 2021; 14 (21) 2377-2387
- 79 Traenka C, Engelter ST, Brown MM, Dobson J, Frost C, Bonati LH. Silent brain infarcts on diffusion-weighted imaging after carotid revascularisation: A surrogate outcome measure for procedural stroke? A systematic review and meta-analysis. Eur Stroke J 2019; 4 (02) 127-143
- 80 Gensicke H, Zumbrunn T, Jongen LM. et al; ICSS-MRI Substudy Investigators. Characteristics of ischemic brain lesions after stenting or endarterectomy for symptomatic carotid artery stenosis: results from the international carotid stenting study-magnetic resonance imaging substudy. Stroke 2013; 44 (01) 80-86
- 81 Musiałek P, Hopkins LN, Siddiqui AH. One swallow does not a summer make but many swallows do: accumulating clinical evidence for nearly-eliminated peri-procedural and 30-day complications with mesh-covered stents transforms the carotid revascularisation field. Adv Interv Cardiol 2017; 13 (02) 95-106
- 82 Karpenko A, Bugurov S, Ignatenko P. et al. Randomized Controlled Trial of Conventional Versus MicroNet-Covered Stent in Carotid Artery Revascularization: 12-Month Outcomes. JACC Cardiovasc Interv 2023; 16 (07) 878-880
- 83 Musialek P, Langhoff R, Stefanini M, Gray WA. Carotid stent as cerebral protector: the arrival of Godot. J Cardiovasc Surg (Torino) 2023; 64 (06) 555-560
- 84 Mauriello A, Servadei F, Sangiorgi G. et al. Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion. Atherosclerosis 2011; 218 (02) 356-362
- 85 de Donato G, Setacci F, Sirignano P, Galzerano G, Cappelli A, Setacci C. Optical coherence tomography after carotid stenting: rate of stent malapposition, plaque prolapse and fibrous cap rupture according to stent design. Eur J Vasc Endovasc Surg 2013; 45 (06) 579-587
- 86 Okazaki T, Sakamoto S, Shinagawa K. et al. Detection of in-stent protrusion (ISP) by intravascular ultrasound during carotid stenting: Usefulness of stent-in-stent placement for ISP. Eur Radiol 2019; 29 (01) 77-84
- 87 Musialek P, de Donato G. Carotid artery revascularization using the endovascular route. In: Peripheral Interventions–Practical Guide. Turin: Edizioni Minerva Medica; 2023: 142-72
- 88 Sardar P, Chatterjee S, Aronow HD. et al. Carotid artery stenting versus endarterectomy for stroke prevention: a meta-analysis of clinical trials. J Am Coll Cardiol 2017; 69 (18) 2266-2275
- 89 Brott TG, Calvet D, Howard G. et al; Carotid Stenosis Trialists' Collaboration. Long-term outcomes of stenting and endarterectomy for symptomatic carotid stenosis: a preplanned pooled analysis of individual patient data. Lancet Neurol 2019; 18 (04) 348-356
- 90 Rosenfield K, Matsumura JS, Chaturvedi S. et al; ACT I Investigators. ACT I Investigators. Randomized trial of stent versus surgery for asymptomatic carotid stenosis. N Engl J Med 2016; 374 (11) 1011-1020
- 91 Halliday A, Bulbulia R, Bonati LH. et al; ACST-2 Collaborative Group. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet 2021; 398 (10305): 1065-1073
- 92 Mazurek A, Malinowski K, Rosenfield K. et al. CARMEN (CArotid Revascularization Systematic Reviews and MEta-aNalyses) Investigators. Clinical Outcomes of Second-versus First-Generation Carotid Stents: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11: 4819
- 93 Metzger DC. (on behalf of CGUARDIANS FDA-IDE Trial Investigators). 30-Day Results From the C-Guardians Pivotal Trial of the CGuard™ Carotid Stent System. Available from: https://vivafoundation.org/news-article?id = 17808 [accessed 12 November 2023]
- 94 Mazurek A, Malinowski K, Sirignano P. et al; CArotid Revascularization systematic reviews and MEta-aNalyses (CARMEN) Collaborators. Carotid artery revascularization using second generation stents versus surgery: a meta-analysis of clinical outcomes. J Cardiovasc Surg (Torino) 2023; 64 (06) 570-582
- 95 Halliday A, Harrison M, Hayter E. et al; Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet 2010; 376 (9746): 1074-1084
- 96 Machalińska A, Kowalska-Budek A, Kawa MP. et al. Effect of carotid endarterectomy on retinal function in asymptomatic patients with hemodynamically significant carotid artery stenosis. Pol Arch Intern Med 2017; 127 (11) 722-729
- 97 Trystuła M, Musiałek P. Transient flow reversal combined with sustained embolic prevention in transcervical revascularization of symptomatic and highly-emboligenic carotid stenoses for optimized endovascular lumen reconstruction and improved peri- and post-procedural outcomes. Adv Interv Cardiol 2020; 16 (04) 495-506
- 98 Kumins NH, King AH, Ambani RN. et al. Anatomic criteria in the selection of treatment modality for atherosclerotic carotid artery disease. J Vasc Surg 2020; 72 (04) 1395-1404
- 99 Galyfos GC, Tsoutsas I, Konstantopoulos T. et al. Early and late outcomes after transcarotid revascularisation for internal carotid artery stenosis: a systematic review and metaanalysis. Eur J Vasc Endovasc Surg 2021; 61 (05) 725-738
- 100 Leckie K, Tanaka A, Dakour-Aridi H. et al. Predictors of 30-Day Stroke and Death After Transcarotid Revascularization. J Surg Res 2023; 283: 146-151
- 101 Trystula M, Van Herzele I, Kolvenbach R. et al. Next-generation transcarotid artery revascularization: transcarotid flOw reversal cerebral protection and CGUARD MicroNET-Covered embolic prevention stent system to reduce strokes – TOPGUARD Study. J Cardiovasc Surg 2024;65 [in press]
- 102 Sharma M, Hart RG, Connolly SJ. et al. Stroke outcomes in the COMPASS trial. Circulation 2019; 139 (09) 1134-1145
- 103 Schwartz GG, Szarek M, Bittner VA. et al; ODYSSEY Outcomes Committees and Investigators. Lipoprotein(a) and benefit of PCSK9 inhibition in patients with nominally controlled LDL cholesterol. J Am Coll Cardiol 2021; 78 (05) 421-433
- 104 Siudut J, Ząbczyk M, Wołkow P, Polak M, Undas A, Jawień J. Intensive low-density lipoprotein cholesterol lowering improves fibrin clot properties: Association with lipoproteins and C-reactive protein. Vascul Pharmacol 2022; 144: 106977
- 105 Paszek E, Pociask E, Ząbczyk M. et al. Active factor XI is associated with the risk of cardiovascular events in stable coronary artery disease patients. Atherosclerosis 2022; 346: 124-132
- 106 Stabile E, de Donato G, Musialek P. et al. Use of Dual-Layered Stents in Endovascular Treatment of Extracranial Stenosis of the Internal Carotid Artery: Results of a Patient-Based Meta-Analysis of 4 Clinical Studies. JACC Cardiovasc Interv 2018; 11 (23) 2405-2411
- 107 Mazurek A, Borratynska A, Malinowski KP. et al. MicroNET-covered stents for embolic prevention in patients undergoing carotid revascularisation: twelve-month outcomes from the PARADIGM study. EuroIntervention 2020; 16 (11) e950-e952
- 108 Dzierwa K, Kedziora A, Tekieli L. et al. Endovascular carotid revascularization under open-chest extracorporeal circulation combined with cardiac surgery in unstable patients at increased risk of carotid-related stroke: SIMultaneous urgent cardiac surgery and MicroNet-covered stent carotid revascularization in extreme-risk patients-SIMGUARD Study. J Cardiovasc Surg (Torino) 2023; 64 (06) 591-607
- 109 Mazurek A, Partyka L, Trystula M. et al. Highly-calcific carotid lesions endovascular management in symptomatic and increased-stroke-risk asymptomatic patients using the CGuard™ dual-layer carotid stent system: Analysis from the PARADIGM study. Catheter Cardiovasc Interv 2019; 94 (01) 149-156
- 110 Eckstein HH, Reiff T, Ringleb P, Jansen O, Mansmann U, Hacke W. et al; SPACE 2 Investigators. SPACE-2: a missed opportunity to compare carotid endarterectomy, carotid stenting, and best medical treatment in patients with asymptomatic carotid stenoses. Eur J Vasc Endovasc Surg 2016; 51 (06) 761-765
- 111 Musiałek P. TASTE-less endpoint of 30-day mortality (and some other issues with TASTE) in evaluating the effectiveness of thrombus aspiration in STEMI: not the “evidence” to change the current practice of routine consideration of manual thrombus extraction. Kardiol Pol 2014; 72 (06) 479-487
- 112 Dzierwa K, Capoccia L, Knapik M. et al. Saving the brain in carotid-related stroke: patient pathways, treatment strategies. J Cardiovasc Surg 2024 [in press]
- 113 Gaba K, Ringleb PA, Halliday A. Asymptomatic carotid stenosis: intervention or best medical therapy?. Curr Neurol Neurosci Rep 2018; 18 (11) 80
- 114 Aro E, Ijäs P, Vikatmaa L. et al. The efficacy of carotid surgery by subgroups: the concept of stroke prevention potential. Eur J Vasc Endovasc Surg 2019; 58 (01) 5-12
- 115 Cohen DJ, Stolker JM, Wang K. et al; CREST Investigators. Health-related quality of life after carotid stenting versus carotid endarterectomy: results from CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial). J Am Coll Cardiol 2011; 58 (15) 1557-1565
- 116 Trystuła M, Tomaszewski T, Pąchalska M. Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): confounder-controlled analysis. Adv Interv Cardiol 2019; 15 (02) 226-233
- 117 Cleveland TJ, Gaines PA, Venables GS. Carotid artery stenosis. Patients should have access to all treatments. BMJ 2010; 340: c1467
- 118 Högberg D, Björck M. Response to “Re. Five year outcomes in men screened for carotid artery stenosis at 65 years of age: a population based cohort study”. Eur J Vasc Endovasc Surg 2020; 59 (01) 152