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The High Risk of Low Distal Flow
Symptomatic atherosclerosis of the vertebral artery remains a challenging condition with no proven interventional therapy. Completed randomized trials of angioplasty with or without stenting involving patients with symptomatic vertebral artery stenosis include Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), Stenting vs Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS), and Vertebral Artery Stenting Trial (VAST). As the largest (N = 115) completed trial, VAST illustrates many of the challenges of developing interventional therapy for this patient pop...
Source: JAMA Neurology - December 21, 2015 Category: Neurology Source Type: research

Outcomes After Carotid Artery Stenting in Medicare Beneficiaries, 2005 to 2009
Conclusions and RelevanceCompeting risks may limit the benefits of CAS in certain Medicare beneficiaries, particularly among older and symptomatic patients who have higher periprocedural and long-term mortality risks. The generalizability of trials like the SAPPHIRE or CREST to the Medicare population may be limited, underscoring the need to evaluate real-world effectiveness of carotid stenosis treatments.
Source: JAMA Neurology - January 12, 2015 Category: Neurology Source Type: research