Giuseppe Lanzino, MD, Alejandro A. Rabinstein, MD, Robert D. Brown, MD

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Treatment of Carotid Artery Stenosis: Medical Therapy, Surgery, or Stenting? Giuseppe Lanzino, MD, Alejandro A. Rabinstein, MD, Robert D. Brown, MD Mayo Clinic Proceedings Volume 84, Issue 4, Pages 362-368 (April 2009) DOI: 10.4065/84.4.362 Copyright © 2009 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE Carotid angioplasty and stenting. A, Large catheter (guide catheter, not shown) is placed in the common carotid artery proximal to the stenosis. Through this catheter, a filter wire is used to cross the stenosis and deploy a filter (distal protection) in the internal carotid artery distal to the plaque. The filter captures emboli dislodged during the procedure. B, Angioplasty (predilatation) of the plaque is performed with an angioplasty balloon, followed by stent deployment (C). Occasionally, angioplasty may be necessary after stenting to further dilate residual stenosis. D, The filter is “captured” and withdrawn into the guide catheter. The procedure is done with full heparinization. Patients receive maintenance dual antiplatelet therapy, usually aspirin plus clopidogrel, for at least 4 to 6 weeks. Mayo Clinic Proceedings 2009 84, 362-368DOI: (10.4065/84.4.362) Copyright © 2009 Mayo Foundation for Medical Education and Research Terms and Conditions