Document Detail


A Surgeon's View on Endarterectomy and Stenting in 2011: Lest We Forget, It's All About Preventing Stroke.
MedLine Citation:
PMID:  22006028     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
It has been nearly 60 years since Felix Eastcott published his seminal paper on carotid reconstruction, which paved the way for carotid endarterectomy (CEA) and then carotid artery stenting (CAS) to assume prominent roles in the prevention of stroke. Yet the ensuing 60 years has witnessed repeated cycles of challenges to practice, professional mistrust, conflicts of interest, dogmatic retention of traditional management strategies, inappropriate corporate interventions, and a general failure to adapt to new evidence. Even the performance of large-scale randomised trials has been associated with rancour and a lack of consensus. This article reviews the history of invasive interventions in the treatment of carotid disease and makes a plea to both the surgical and interventional communities that the fundamental priority must always be the prevention of stroke. It concludes with an appeal for colleagues to collaborate to determine how best to treat patients during the hyperacute period after the onset of symptoms and to identify a smaller cohort of asymptomatic patients who are truly at high risk for stroke in whom to target CAS or CEA.
Authors:
A Ross Naylor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-18
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  -     ISSN:  1432-086X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Vascular Surgery Group, Division of Cardiovascular Sciences, Leicester Royal Infirmary, Clinical Sciences Building, Leicester, LE2 7LX, UK, ross.naylor@uhl-tr.nhs.uk.
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