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Angioplasty and stenting for stroke prevention

Good questions that need answers

From the Department of Neurology and the Comprehensive Stroke Program (Dr. Chaturvedi), and the Department of Neurological Surgery (Dr. Fessler), Wayne State University/Detroit Medical Center, MI.

Address correspondence and reprint requests to Dr. Seemant Chaturvedi, 8C-UHC, Department of Neurology, Wayne State University, 4201 St. Antoine, Detroit, MI 48201; e-mail: Schaturv{at}med.wayne.edu

Extracranial and intracranial angioplasty and stenting of the cerebral vessels are being performed more frequently. One clinical trial demonstrated equivalent outcomes between extracranial carotid angioplasty and carotid endarterectomy, but the results in both groups were suboptimal. Concerns remain about the iatrogenic stroke rate after angioplasty, especially for asymptomatic patients. Angioplasty, with or without stent placement, also offers a potential new therapeutic approach for patients with intracranial stenosis and vertebrobasilar lesions, although these procedures have been performed in uncontrolled fashion.

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