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KMID : 0858420090110030116
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Korean Journal of Stroke
2009 Volume.11 No. 3 p.116 ~ p.122
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Management of Periprocedural Complications and Hyperperfusion Syndrome in Carotid Stenting
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Kim Gyeong-Moon
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Abstract
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Although carotid endarterectomy (CEA) is the established gold standard for carotid revascularization, with the evolution and maturation of carotid artery stenting (CAS) equipment and technique, CAS is now a reasonable alternative to CEA, particularly in patients at high risk for CEA. Embolic protection, improving stent designs, and ever-increasing surgeon expe-rience are propelling CAS towards equipoise with and possible superiority to CEA. Many nonrandomized and randomized CAS clinical trials have been performed and there are at least 4 randomized clinical trials in progress, comparing CEA and CAS with embolic prevention devices (EPD) in low-risk patients. Depending on the results of ongoing and future trials, CAS may become the treatment of choice for many patients who are now treated by CEA and for patients who require revas-cularization but are at high risk for CEA. We review the data published to date regarding the patient selection, periprocedural management, and hyperperfusion syndrome in CAS.
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KEYWORD
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Carotid stenosis, Complication, Hyperfusion syndrom, Stent,
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