Published online before print August 10, 2006, doi: 10.1161/01.STR.0000236101.09480.b7
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(Stroke. 2006;37:2400.)
© 2006 American Heart Association, Inc.
Comments, Opinions, and Reviews |
Carotid Artery Stenting
First Consensus Document of the ICCS-SPREAD Joint Committee
From Stroke Prevention and Educational Awareness Diffusion (A.B., G.F.G., G.L., S.M., C.P., S.R., C.S., A.Z.); Società Italiana di Cardiologia Interventistica (Italian Society of Interventional Cardiology) (L.B., A.C.); Associazione Italiana di NeuroRadiologia (National Association of Neuroradiology) (F.B., S.M.); Società Italiana di Chirurgia Vascolare e Endovascolare (Italian Society of Vascular and Endovascular Surgery) (G.d.D., G.L., C.P., C.S.); Società Italiana di Cardiologia (Italian Society of Cardiology) (G.D.S.); Società Italiana di Neurologia (Italian Society of Neurology) (D.I.); Società Italiana di Radiologia Medica (Italian Society of Medical Radiology) (L.L., U.U.); Associazione Nazionale Medici Cardiologi Ospedalieri (National Association of Hospital Cardiologists) (B.R.); and the Italian Consensus on Carotid Stenting (L.B., F.B., A.C., G.d.D., G.D.S., D.I., L.L., C.P., B.R., C.S., U.U.).
Correspondence to (for ICCS) Alberto Cremonesi, MD, Department of Medical and Surgical Cardiology, Villa Maria, Cecilia Hospital, Via Corriera 1, 48010 Cotignola (RA), Italy. E-mail acremonesi{at}gvm-vmc.it or (for SPREAD) Gian Franco Gensini, Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Medical School, University of Florence, Viale Morgagni 85, 50100, Florence, Italy. E-mail gfgensini@tin.it; g.gensini@dfc.unifi.it
Background and Purpose— The prevention of stroke and the correct treatment of carotid artery stenosis represent today a major debate in cardiovascular medicine. Beside carotid endarterectomy, carotid angioplasty and stenting is becoming more widely performed for the treatment of severe carotid obstructive disease, and is now accepted as a less invasive technique that may provide an alternative for selected patients, particularly those with significant comorbidities. An Italian multidisciplinary task force, in which converged the most representative scientific societies involved in carotid treatment, was created to provide neurologists, radiologist, cardiologists, vascular surgeons, and all those involved in prevention and treatment of carotid disease with a simple, clear and updated evidence-based consensus document.
Summary of Review— This First Consensus Document of the ICCS (Italian Consensus Carotid Stenting)/SPREAD group addressed the main issues related to methodology, definition of symptomatic and asymptomatic carotid stenosis, indication and procedures for carotid artery stenting, including the use of devices for preventing procedural embolic complications. Special attention was paid to credentials and competency for physicians qualifications to perform vascular angioplasty and stent placement, including training, acceptable complication rates and certification.
Conclusions— As any guideline or consensus statement, also this document is valid as long as the evidence on which it is based remains up-to-date. In such a fast-evolving field of medicine as the management of carotid stenosis, it is mandatory to stimulate a continuous and fruitful discussion among all the professionals involved in this very evolutionary field.
Key Words: carotid stenosis • consensus statement
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