Author + information
- Received November 8, 2019
- Accepted November 19, 2019
- Published online February 10, 2020.
- Joshua A. Beckman, MDa,∗ (, )@joshuabeckmanmd@vivaphysicians,
- Gary M. Ansel, MDb,
- Sean P. Lyden, MDc and
- Tony S. Das, MDd
- aCardiovascular Division, Vanderbilt University Medical Center, Nashville, Tennessee
- bDepartment of Cardiology, Riverside Methodist Hospital, Columbus, Ohio
- cDepartment of Vascular Surgery, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- dHeart and Vascular Division, Texas Health Dallas, Dallas, Texas
- ↵∗Address for correspondence:
Dr. Joshua A. Beckman, Cardiovascular Division, Vanderbilt University Medical Center, 1215 21st Avenue South, MCE 5472, Nashville, Tennessee 37215.
• Recent clinical trials have advanced the evidence supporting carotid artery stenting in asymptomatic internal carotid artery stenosis.
• With the current evidence base, carotid artery stenting should be reimbursed for use in appropriate patients.
• Standardization in training, data collection, and reporting should be developed and required.
The advance of therapies to reduce the stroke impact of asymptomatic carotid artery stenosis has proved difficult over the last decade. Disagreement concerning the underlying randomized control trials has limited entry into the care arena of endovascular therapies. Recently, advances in percutaneous therapies for carotid artery disease have been reported and provide a substantial database supporting the further incorporation of endovascular-based therapies in patients who need revascularization and meet selection criteria. With a second randomized control trial now published, it is time for a re-evaluation of endovascular therapy as a component of carotid artery care. This review describes the advances in the field in the last 5 years, clarifying the current position of these therapies in the care of the patient with asymptomatic carotid artery disease.
Dr. Beckman has been a consultant for Antidote Therapeutics, Amgen, AstraZeneca, Boehringer Ingelheim, Merck, Novo Nordisk, GlaxoSmithKline, and Sanofi; and has served on data and safety monitoring boards for Novartis and Bayer. Dr. Ansel has been a consultant for Medtronic, Boston Scientific, Phillips, CR Bard, Cook, Surmodics, Abbott Vascular, and W.L. Gore; and has received royalties from Cook Medical. Dr. Lyden has been a consultant for Endologix and PQ Bypass. Dr. Das has received honoraria from Abbott, Boston Scientific, LivMor, and National Cardiovascular Partners; has been a consultant for Abbott, Boston Scientific, Cardinal Health, and National Cardiovascular Partners; is a stockholder in Janacare and LivMor; and has received research funding from Boston Scientific and LivMor.
- Received November 8, 2019.
- Accepted November 19, 2019.
- 2020 American College of Cardiology Foundation
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