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Carotid stent in the treatment of carotid stenosis: a debate
Cardiovascular Surgery, Vol. 5, No. 5, p. 453, 1997 1997 Published by Elsevier Science Ltd. Printed in Great Britain 0967–2109/97 $17.00 + 0.00
PII: S0967-2109(97)00046-X
CREST EDITORIALS INTRODUCTION
Carotid stent in the treatment of carotid stenosis: a debate J. S. Yao Division of Vascular Surgery, Department of Surgery, Northwestern University Medical School, 251E Chicago Ave, #628, Chicago IL 60611-2797, USA
In recent months, carotid angioplasty with placement of a stent has emerged as an alternate treatment for carotid artery stenosis. Interest in this technology is intense and nearly every specialty involved in the care of cerebrovascular disease has published an editorial on this subject [1–6]. In this issue, we invited Drs Robert Hobson and Pat Clagett to write about the two trials that are now being organized. These are CREST (Carotid Revascularization Endarterectorny versus Stent Trail) by Hobson et al. and the CASET (Carotid Artery versus Endarterectomy Trial) by Clagett and his colleagues. We also asked one of the pioneers in carotid surgery, Dr Jesse Thompson, to give us his perspective on this new technology. In any clinical trials, patient safety must be prime responsibility; Dr William Baker will discuss moral and ethical consideration of carotid stent trial. We must remember Medicine’s first rule: ‘Do
CARDIOVASCULAR SURGERY
OCTOBER 1997 VOL 5 NO 5
no harm’. But it can be so easy to do harm if this technology is applied indiscriminately to patients.
References 1. Naylor, A. R., London, N. J. M. and Bell, P. R. F., Carotid endarterectomy versus carotid angioplasty. Lancet, 1997, 349, 203–204. 2. McGuinness, C. L. and Burnand, K. G., Percutaneous transluminal angioplasty of the internal carotid artery. British Journal of Surgery, 1996, 83, 1171–1173. 3. Grotta, J., Elective stenting of extracranial carotid arteries. Circulation, 1997, 95, 303–305. 4. HASH(0x95a098) Carotid angioplasty and stent: An alternative to carotid endarterectomy. Neurosurgery, 1997, 40, 344–345. 5. HASH(0x95bc18) North American Chapter. Point of View: statement regarding carotid angipoplasty and stenting. Journal of Vasculcar Surgery, 1996, 24, 900. 6. Becker, G. J., Should metallic vascular stents be used to treat cerebrovascular occlusive diseases?. Radiology, 1994, 191, 309–312. Paper accepted 21 April 1997
453
PII: S0967-2109(97)00046-X
CREST EDITORIALS INTRODUCTION
Carotid stent in the treatment of carotid stenosis: a debate J. S. Yao Division of Vascular Surgery, Department of Surgery, Northwestern University Medical School, 251E Chicago Ave, #628, Chicago IL 60611-2797, USA
In recent months, carotid angioplasty with placement of a stent has emerged as an alternate treatment for carotid artery stenosis. Interest in this technology is intense and nearly every specialty involved in the care of cerebrovascular disease has published an editorial on this subject [1–6]. In this issue, we invited Drs Robert Hobson and Pat Clagett to write about the two trials that are now being organized. These are CREST (Carotid Revascularization Endarterectorny versus Stent Trail) by Hobson et al. and the CASET (Carotid Artery versus Endarterectomy Trial) by Clagett and his colleagues. We also asked one of the pioneers in carotid surgery, Dr Jesse Thompson, to give us his perspective on this new technology. In any clinical trials, patient safety must be prime responsibility; Dr William Baker will discuss moral and ethical consideration of carotid stent trial. We must remember Medicine’s first rule: ‘Do
CARDIOVASCULAR SURGERY
OCTOBER 1997 VOL 5 NO 5
no harm’. But it can be so easy to do harm if this technology is applied indiscriminately to patients.
References 1. Naylor, A. R., London, N. J. M. and Bell, P. R. F., Carotid endarterectomy versus carotid angioplasty. Lancet, 1997, 349, 203–204. 2. McGuinness, C. L. and Burnand, K. G., Percutaneous transluminal angioplasty of the internal carotid artery. British Journal of Surgery, 1996, 83, 1171–1173. 3. Grotta, J., Elective stenting of extracranial carotid arteries. Circulation, 1997, 95, 303–305. 4. HASH(0x95a098) Carotid angioplasty and stent: An alternative to carotid endarterectomy. Neurosurgery, 1997, 40, 344–345. 5. HASH(0x95bc18) North American Chapter. Point of View: statement regarding carotid angipoplasty and stenting. Journal of Vasculcar Surgery, 1996, 24, 900. 6. Becker, G. J., Should metallic vascular stents be used to treat cerebrovascular occlusive diseases?. Radiology, 1994, 191, 309–312. Paper accepted 21 April 1997
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