ABSTRACT
This chapter includes information and discussion about endovascular intervention in the aortic arch branches. Be aware that no stents are approved for usage in these arteries as of yet. Angioplasty and stenting of the carotid bifurcation are not included in this chapter. There are signi Qcant di Rerences between interventions in the carotid bifurcation and those in the common carotid and subclavian-axillary arteries. Carotid bifurcation intervention should be performed with very thorough anticoagulation and should include a stent. Most symptomatic carotid bifurcation lesions present as a result of cerebral embolization, and the potential for embolization with manipulation is higher than for lesions in other locations. In addition, present conditions include signi Qcant unknowns which indicate that carotid bifurcation angioplasty and stent placement should be performed under the auspices of studies approved by the institutional review board of the particular facility. Lesions of the common carotid and subclavian-axillary arteries are less common, are less likely to embolize, and will probably never be formally evaluated with a large-scale randomized therapeutic trial.
