November 2009

Chief Medical Editor's Page By William A. Gray, MD

CHALLENGING CASES Stent Graft Repair and Coil Embolization for Spontaneous Hemothorax A rare case of spontaneous hemothorax of neurofibromatosis in the chest is treated with combined endovascular repair of stent graft placement and coil embolization. By Wilmo C. Orejola, MD; Elie M. Elmann, MD; and Gregory T. Simonian, MD

COVER STORY CMS and Carotid Artery Stenting Top 5 Viewed CMS's history with carotid and vertebral intervention, including the current status. By Christopher J. White, MD

CAS Outcome Reports A reader’s guide to critical assessment of the literature. By William A. Gray, MD

Impact of the CREST Trial Top 5 Viewed A historical perspective of this trial and a look at some of the tough questions that still remain. By Gary S. Roubin, MD, PhD

CAS in Asymptomatic Patients Top 5 Viewed Is carotid artery stenting justified for patients with asymptomatic carotid artery stenosis? By Sumaira Macdonald, MBChB (Comm.), FRCP, FRCR, PhD
Commentary by Issam D. Moussa, MD

Concepts in Stent Design, Carotid Access, and Embolic Protection Top 5 Viewed A review of technological developments aimed at establishing CAS as a suitable alternative to carotid endarterectomy. By Mark H. Wholey, MD

An Algorithmic Approach to Carotid Access Top 5 Viewed A review of the techniques and possible complications associated with accessing this difficult anatomy. By Subbarao Myla, MD, FACC, FSCAI

CAS Device Update

FEATURED TECHNOLOGY FiberNet Embolic Protection System A new era of distal protection during carotid artery stenting? By Billy J. Kim, MD, and Thomas S. Maldonado, MD

TODAY'S PRACTICE The Global Approach to Cardiovascular Disease It’s time to get on board with multispecialty collaboration. By Alex Powell, MD, and Ramon Quesada, MD

DEPARTMENTS Innovations

An Interview With Anton N. Sidawy, MD, MPH The SVS President discusses the critical role of education, advocacy, and new media in the better treatment of patients.

The State of Carotid Embolic Protection and the Role of Flow Reversal A panel of carotid stenting experts engages in a candid discussion of data, devices, decisions, and the future of embolic protection in carotid stenting procedures.

Microembolization: The Achilles’ Heel of CAS? The incidence of procedural microembolization may depend on the type of EPD employed. By Sumaira Macdonald, MBCHB, FRCP, FRCR, PhD; Barry T. Katzen, MD, FACC, FACR, FSIR; AND Claudio Schönholz, MD

The Albany Vascular Group Experience Embolic protection during carotid artery stenting using the GORE Flow Reversal System. By MANISH MEHTA, MD, MPH; JOHN B. TAGGERT, MD; YARON STERNBACH, MD; PAUL B. KREIENBERG, MD; SEAN P. RODDY, MD; PHILIP S.K. PATY, MD; KATHLEEN J. OZSVATH, MD; BENJAMIN B. CHANG, MD; DHIRAJ M. SHAH, MD; AND R. CLEMENT DARLING III, MD

The Emory Experience A review of carotid stenting, flow reversal, microembolization, and vascular dementia. By KARTHIKESHWAR KASIRAJAN, MD, AND LUKE BREWSTER, MD

Stroke Prevention in Carotid Artery Stenting Gary Ansel, MD, discusses the goals and challenges of embolic protection, the potential of flow reversal, and how stroke rates have improved over the past decade.