Portal de Periódicos da CAPES

Carotid Artery Stenting

2022; Elsevier BV; Volume: 80; Issue: 2 Linguagem: Inglês

10.1016/j.jacc.2022.05.007

1558-3597

Christopher J. White, Thomas G. Brott, William A. Gray, Donald Heck, Tudor Jovin, Sean P. Lyden, D. Christopher Metzger, Kenneth Rosenfield, Gary S. Roubin, Ravish Sachar, Adnan H. Siddiqui,

Acute Ischemic Stroke Management

Significant advances in the field of carotid artery stenting (CAS) have occurred, including new randomized trial data, recent professional societal statements for competency, new techniques and new devices that have been developed, and perhaps most importantly, our understanding of how to better select candidates for CAS to avoid periprocedural complications. The current Centers for Medicare and Medicaid Services coverage decision regarding CAS is outdated, and our review supports our recommendation to approve CAS in selected candidates who are symptomatic with a carotid stenosis ≥50% and ≤99% and for asymptomatic patients with carotid stenosis ≥70% and ≤99% for stroke prevention. Optimized CAS strategies have allowed experienced operators to better assess procedure risk before CAS and have led to continued improvement in CAS outcomes. New technologies including enhanced embolic protection devices and dual-layered stents should result in further improvement.