Carotid Artery Stenting: The Basics

Saw J, ed. Carotid Artery Stenting: The Basics. Humana Press 2009, 264 pages, 29 illustrations, $189.00.

Carotid Artery Stenting: The Basics should be retitled An Introduction. The book is edited by Jacqueline Saw an interventional cardiologist. The text consists of 267 pages separated into 5 parts by 15 chapters. The contributors are 15 interventional cardiologists, 3 neurologists, 2 vascular surgeons, and 1 radiologist. The text is richly referenced with cardiology and vascular surgery journals. Each chapter covers approximately 20 pages with evaluation of carotid artery stenosis evaluation, management, and technical approaches to carotid artery stenting. There is extensive discussion of the different carotid stenting registries and randomized trials in Chapter 3. In Chapter 5 noninvasive imaging of the extracranial carotid circulation is covered in 20 pages. MR angiography and its physics are explained in five paragraphs. CT angiography is covered in six paragraphs so the non-imaging practioner can now skip the weekend credentialing course. The chapter on “Aortic Arch”, cerebrovascular anatomy and angiography is twenty pages in length with one of thirteen references from a radiology journal or text. There is an eight page section covering the vascular anatomy of the anterior and posterior circulation. I am not sure Drs. Newton/Potts could be so concise.

Section 2 with laboratory setup and noninvasive imaging discusses the various options for carotid cerebral vascular imaging with cine angiogram with bolus chasing as well as other “options” depending on other avenues of intervention anticipated (coronary, peripheral, and cerebrovascular). There are a limited number of images and figures in the text with arrows pointing to each anatomic structure or its associated pathology.

Part 5 discusses the technical approach to carotid stenting from the cardiologist prospective with radial, brachial, direct carotid puncture, and femoral artery access. Four diagrams provide the reader in how to locate and puncture the femoral artery.

Chapter 13 is written by interventional neurologists who describe the endovascular treatment of acute ischemic stroke. They recommend performing angiography to identify the artery involved as well as to “exclude the presence of large thrombosed aneurysms or arteriovenous malformations or vascular brain tumors all of which should be considered contraindications to thrombolysis”.

In summary, this is a book written, referenced, and intended for the non neuroscience specialists interested in learning the basics of neuroimaging and neurointervention in 264 pages. I cannot recommend this text to anyone other than medical students who want an “introduction” into carotid imaging and intervention.

Carotid Artery Stenting: The Basics