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Printable Handouts
Navigable Slide Index
- Introduction
- Stenosis of the internal carotid artery
- Lecture outline
- Symptoms of carotid stenosis (1)
- A prominent posterior communicating artery
- Symptoms of carotid stenosis (2)
- Superficial borderzone infarction
- Deep borderzone infarction
- Impaired perfusion in deep borderzones
- Other symptoms of carotid artery disease
- Signs of carotid artery disease
- Examination low flow retinopathy
- Cholesterol embolus with retinal infarction
- Indications for carotid endarterectomy
- Stenosis treatment should be evidence based
- Mechanisms of ischaemic stroke
- Analysis of symptomatic carotid surgery trials
- Different methods to measure stenosis
- Analysis results: stenosis 70-99%
- Angiograms of severe stenosis and near occlusion
- Analysis results: near occlusion
- Absolute risk reduction with surgery
- Benefit of carotid endarterectomy
- The effect of surgery by time since last event
- Risk of recurrent stroke prior to endarterectomy
- Carotid endarterectomy for asymptomatic stenosis
- Asymptomatic carotid surgery trial
- Main results of ACST trial
- Carotid territory ischaemic stroke: 5-years risk
- Combined analysis of ACST and ACASA trials
- Benefit from surgery for asymptomatic patients
- HPS study
- Is angioplasty or stenting an alternative?
- Endovascular treatment - alternative to surgery?
- Carotid endarterectomy specimen
- What have we learnt from CAVATAS?
- Inflated angioplasty balloon
- Carotids fit for surgery
- CAVATAS results (1)
- CAVATAS results (2)
- Histology of restenosis after angioplasty
- Conclusions from CAVATAS
- Evolution of endovascular treatment
- Self expanding nitenol stent
- Cerebral protection devices
- Parodi anti-embolism system
- Disadvantages of protection devices
- CAVATAS: timing of strokes after treatment
- Recent prospective case series and registries
- Problems with case series and registry data
- Accuracy of outcome event assessment
- Importance of randomised control trials
- Carotid angioplasty and stenting vs. surgery
- SAPPHIRE trial
- SAPPHIRE trial: intention to treat analysis
- SAPPHIRE trial: results
- SAPPHIRE trial: notable features
- EVA-3S trial: 30 day safety data
- Explanations for the difference in EVA-3S
- CAVATAS: effect of carotid angioplasty/stenting
- SPACE: 30 day safety data
- SPACE: notable features
- Metanalysis of endovascular treatment vs. surgery
- Metanalysis results: stroke or death at 30 days
- Metanalysis results: MI, death, stroke at 30 days
- Metanalysis results: cranial neuropathy
- Metanalysis results: other comparisons
- Numbers of patients included in the metanalysis
- Endovascular vs. surgical treatment: conclusions
- On-going trials of carotid stenting
- Conclusions: treatment of symptomatic stenosis
- Conclusions: endarterectomy after stroke or TIA
- Conclusions: treatment for asymptomatic stenosis
- Conclusions: carotid stenting
- Acknowledgements
Topics Covered
- Symptoms and signs of carotid stenosis
- Imaging features
- Indications for carotid endarterectomy for symptomatic stenosis
- Indications for carotid endarterectomy for asymptomatic stenosis
- Are angioplasty and stenting safe and effective alternatives?
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Brown, M. (2008, October 27). Carotid endarterectomy, angioplasty and stenting [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 11, 2024, from https://doi.org/10.69645/YTVR2010.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Martin Brown has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.