Update on Percutaneous Management of Carotid Bifurcation Disease

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Update on Percutaneous Management of Carotid Bifurcation Disease

R. Kevin Rogers^, Fahad Younas
Department of Medicine, Division of Cardiology, Section of Vascular Medicine, University of Colorado School of Medicine, Aurora, CO, USA
^Corresponding author: R. Kevin Rogers, Department of Medicine, Division of Cardiology, Section of Vascular Medicine, University of Colorado School of Medicine, Aurora, CO, USA. Tel: +17208486506; Fax: +17208487315; Email: kevin.rogers@ucdenver.edu
Received Date: 01 September, 2018; Accepted Date: 02 October, 2018; Published Date: 09 October, 2018

Citation: Rogers RK, Younas F (2018) Update on Percutaneous Management of Carotid Bifurcation Disease. Int J Angiol Vasc Surg: IJAVS-108. DOI: 10.29011/ IJAVS -108/100008

1. Abstract

Carotid artery revascularization has shown better outcomes for carotid artery disease management when compared to medical therapy alone, particularly for symptomatic patients. However, we still debate whether revascularization is beneficial for asymptomatic patients in the setting of contemporary medical therapy. The mode of revascularization Carotid Artery Stenting (CAS) or Carotid Endarterectomy (CEA) has also been debated. Earlier trials showed favorable outcomes for CEA versus CAS, but more recent data with contemporary devices and more operator experience suggest equivalent outcomes. Though some clinical guidelines for the prevention of stroke concluded equipoise for CAS and CEA, the Centers for Medicare and Medicaid Services (CMS) only reimburse CAS for symptomatic patients at a higher risk for surgical complications, thereby limiting its usage. Whether symptomatic or asymptomatic, a patient-centered approach should consider medical management, CAS and CEA as complementary to each other.

2. Keywords: Carotid Artery Disease; Carotid Artery Stenting; Carotid Endarterectomy; Carotid Revascularization; Extracranial Carotid Disease

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International Journal of Angiology and Vascular Surgery