Peri-Procedural Stroke Risk: Cartoid Artery Stenting Versus Carotid Endarteretomy

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  • February 26, 2019
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  • Neri-Mynatt, Gabrielle
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
Abstract
  • STROKE is the 5th leading cause of death in the United States, killing about 130,000 Americans a year. The prevalence of stroke is roughly 3% of the population per year. There are two types of stroke: hemorrhagic and ischemic. Hemorrhagic stroke is caused by bleeding into the cranial cavity while ischemic involves occlusion or restriction of blood flow to an area of the brain. Potential pathophysiologic mechanisms of ischemic stroke include decreased perfusion due to a systemic cause or due to stenosis of a vessel that feeds the brain. Decreased perfusion due to a systemic cause, like persistent hypotension, causes global cerebral hypo perfusion. Vascular occlusion can occur due to plaque or embolization and causes decreased perfusion in the associated vascular bed. Cardioembolism is the most common cause representing about 37% of ischemic strokes. Carotid artery atherosclerosis is a major risk factor and causes 10-15% of ischemic stroke. Atherosclerosis can cause a gradual change in the vessel causing a narrowed area that restricts flow and can accumulate platelets which lead to an acute episode. Risk of stroke from carotid artery stenosis depends on the severity of the stenosis among other risk factors including diabetes and hypertension. Carotid endarterectomy (CEA) is an open surgical procedure was established in 1954 as a reliable treatment for carotid stenosis. In approximately 1990, a clinical trial supported the use of endarterectomy over aspirin alone. Carotid artery stenting is a more recent procedure developed in the 1980s as a less invasive alternative treatment. It is important to compare and contrast each method of treatment to further identify the long-term outcomes associated with each option.
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  • In Copyright
Reviewer
  • Faurot, Keturah
  • Royster, Chad
Degree
  • Master of Health Science
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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  • 03017bbf-d2c5-4c32-b5ff-fb580cd5f16e

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