Document Detail


Evidence-based treatment of carotid artery stenosis.
MedLine Citation:
PMID:  21631221     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Carotid atheromatous disease is an important cause of stroke. Carotid endarterectomy (CEA) is a well-established option for reducing the risk of subsequent stroke due to symptomatic stenosis (> 50%). With adequately low perioperative risk (< 3%) and sufficient life expectancy, CEA may be used for asymptomatic stenosis (> 60%). Recently, carotid angioplasty and stent placement (CAS) has emerged as an alternative revascularization technique. Trial design considerations are discussed in relation to trial results to provide an understanding of why some trials were considered positive whereas others were not. This review then addresses both the original randomized studies showing that CEA is superior to best medical management and the newer studies comparing the procedure to stent insertion in both symptomatic and asymptomatic populations. Additionally, recent population-based studies show that improvements in best medical management may be lowering the stroke risk for asymptomatic stenosis. Finally, the choice of revascularization technique is discussed with respect to symptom status. Based on current evidence, CAS should remain limited to specific indications.
Authors:
Kate C Young; Anunaya Jain; Minal Jain; Robert E Replogle; Curtis G Benesch; Babak S Jahromi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgical focus     Volume:  30     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E2     Citation Subset:  IM    
Affiliation:
Departments of Neurology.
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