Letter: Carotid Artery Angioplasty and Stenting Without Distal Embolic Protection Devices

摘要

Copyright © 2017 by the Congress of Neurological SurgeonsTo the Editor:We read with interest the article by Binning et al1 regarding a less invasive approach to carotid stenting, and applaud the authors’ efforts to reduce the complexity, costs, and risks of the procedure. We are, however, dismayed by the authors claim that “this is the first study to stress the importance of avoiding poststenting angioplasty…” Even a cursory review of the literature would reveal that carotid stenting without angioplasty was first described in 2002,2 and numerous authors from multiple centers have described their experience with the use of self-expanding stents alone or with only prestent angioplasty to safely and effectively treat carotid stenosis.3,4,5 Primary carotid stenting, in which balloons and embolic protection devices are avoided, causes less hemodynamic instability than standard techniques.6 Plaque morphology on computed tomography angiography can select...