Ruolo dell'Angioplastica e Stenting nel Trattamento delle Stenosi Carotidee Extracraniche

The role of angioplasty and stenting in the treatmente of extracranial carotid stenoses - Carotid angioplasty (PTA) is emerging as a less invasive alternative treatment of extracranial carotid stenoses, towards traditional carotid endarterectomy surgical procedure (CEA). Randomized Trials demonstrated the effectiveness of CEA in the prevention of stroke for haemodynamic carotid lesions, both in symptomatic and in asymptomatic patients, but the role of PTA has not jet been defined. Aim and Methods: with the aim of defining the indications to PTA or CEA in carotid bifurcation disease, we examined the pros and cons, taking into account the pertinent literature and our own experience. We analized in detail the procedures utilized in order to reduce the possibility of cerebral embolysm, which is the major complication of carotid angioplasty. Conclusions: on the basis of our previous studies in the computerized elaboration of echo images of the carotid plaque, we set up a Prospective Multicentre Study: the ICAROS Registry, to collect data related to carotid angioplastic procedures. The echographic characteristics of the plaques to be treated will be correlated with the particles filtered during PTA, and with cerebral events during the procedure, or in the follow-up. The ICAROS Study has the aim of defining new criteria for the indication to angioplasty, in order to state its role in the treatment of carotid disease.