New Ischemic Cerebral Lesions After Endarterectomy vs. Stenting for the Treatment of Symptomatic Carotid Stenosis (CARECarotid)

This is an interventional treatment trial for Carotid Artery Stenosis focused on measuring carotid angioplaty, MRI DWI Read More

Inclusion criteria comprised:

• patient's age ≥ 18 years;
• 60-99% stenosis of the internal carotid artery (degree of stenosis assessed by means of Doppler sonography, CT angiography or catheter angiography);
• diameter of the target internal carotid artery not more than 7 mm;
• symptomatic lesion (a history of ipsilateral stroke, transient ischaemic attack or reversible ischaemic neurological deficit);
• localisation and morphology of the lesion making possible surgical eversion endarterectomy or endovascular angioplasty with stent implantation;
• written informed consent.

Exclusion criteria comprised:

• target lesion that has been previously stented;
• highly calcified lesions;
• very tortuous common and internal carotid arteries;
• occlusion of the contralateral carotid artery without adequate collateral circulation through the circle of Willis (revealed by means of transcranial Doppler sonography);
• anatomical contraindications for eversion endarterectomy;
• acute ipsilateral stroke;
• disabling stroke at any side;
• other severe pathologies of the brain resulting is significant loss of cerebral tissue and/or significant neurological deficits, such as extensive previous stroke or multiple lacunar infarcts;
• history of haemorrhagic transformation of ischaemic stroke;
• severe comorbidities (such as cancer or decompensated heart failure);
• allergy to aspirin, clopidogrel or ticlopidine;
• allergy to iodinated contrast media;
• pregnant women;
• women of reproductive age who do not use effective contraception;
• metallic implants (such as peacemakers and orthopaedic endoprostheses) or other known contraindications for magnetic resonance imaging;