Document Detail


Carotid endarterectomy: still the standard of care for carotid bifurcation disease.
MedLine Citation:
PMID:  21718927     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Current treatment guidelines of symptomatic and asymptomatic carotid stenosis are based on studies performed over a decade ago. Since that time, significant advances have been made in medical management, namely high dose statin therapy and improved antiplatelet agents, and in carotid interventions, namely the advent of carotid artery stenting. Especially with carotid stenting, the technology has grown by leaps and bounds and continues to advance at a rapid pace. These advances have necessitated new studies to compare these treatments with the gold standard of carotid endarterectomy. In asymptomatic patients, the current data does not justify medical management alone for severe (>80%) carotid stenosis. Furthermore, in both asymptomatic and symptomatic patients current studies have failed to demonstrate equivalence of CAS to CEA for significant carotid stenosis. Clearly additional studies comparing CAS, CEA, and medical management are needed to further clarify this issue. In the future, advances in CAS technology and techniques may greatly expand the role of CAS beyond its current role in certain high-risk patient subsets. However, for the time being CEA still remains the gold standard for carotid intervention.
Authors:
Caron Rockman; Shang Loh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in vascular surgery     Volume:  24     ISSN:  1558-4518     ISO Abbreviation:  Semin Vasc Surg     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-07-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809602     Medline TA:  Semin Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  10-20     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
New York University Medical School, New York, NY.
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