Asymptomatic carotid stenosis: Intervention or best medical therapy?

<p><h4>Purpose of Review</h4></p> <p>Provide a current overview regarding the optimal strategy for managing patients with asymptomatic carotid artery stenosis.</p> <p><h4>Recent Findings</h4></p> <p>Carotid endarterectomy (CEA) and ca...

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Huvudupphovsmän: Gaba, KA, Ringleb, P, Halliday, A
Materialtyp: Journal article
Språk:English
Publicerad: Springer 2018
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author Gaba, KA
Ringleb, P
Halliday, A
author_facet Gaba, KA
Ringleb, P
Halliday, A
author_sort Gaba, KA
collection OXFORD
description <p><h4>Purpose of Review</h4></p> <p>Provide a current overview regarding the optimal strategy for managing patients with asymptomatic carotid artery stenosis.</p> <p><h4>Recent Findings</h4></p> <p>Carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce long-term stroke risk in asymptomatic patients. However, CAS is associated with a higher risk of peri-procedural stroke. Improvements in best medical therapy (BMT) have renewed uncertainty regarding the extent to which results from older randomised controlled trials (RCTs) comparing outcomes following carotid intervention can be generalised to modern medical practise.</p> <p><h4>Summary</h4></p> <p>‘Average surgical risk’ patients with an asymptomatic carotid artery stenosis of 60–99% and increased risk of late stroke should be considered for either CEA or CAS. In patients deemed ‘high risk’ for surgery, CAS is indicated. Use of an anti-platelet, anti-hypertensive and statin, with strict glycaemic control, is recommended. Results from ongoing large, multicentre RCTs comparing CEA, CAS and BMT will provide clarity regarding the optimal management of patients with asymptomatic carotid artery stenosis.</p>
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spelling oxford-uuid:786034e0-bc29-48c5-919f-c4bfb8ecaf9e2022-03-26T20:30:14ZAsymptomatic carotid stenosis: Intervention or best medical therapy?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:786034e0-bc29-48c5-919f-c4bfb8ecaf9eEnglishSymplectic Elements at OxfordSpringer2018Gaba, KARingleb, PHalliday, A<p><h4>Purpose of Review</h4></p> <p>Provide a current overview regarding the optimal strategy for managing patients with asymptomatic carotid artery stenosis.</p> <p><h4>Recent Findings</h4></p> <p>Carotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce long-term stroke risk in asymptomatic patients. However, CAS is associated with a higher risk of peri-procedural stroke. Improvements in best medical therapy (BMT) have renewed uncertainty regarding the extent to which results from older randomised controlled trials (RCTs) comparing outcomes following carotid intervention can be generalised to modern medical practise.</p> <p><h4>Summary</h4></p> <p>‘Average surgical risk’ patients with an asymptomatic carotid artery stenosis of 60–99% and increased risk of late stroke should be considered for either CEA or CAS. In patients deemed ‘high risk’ for surgery, CAS is indicated. Use of an anti-platelet, anti-hypertensive and statin, with strict glycaemic control, is recommended. Results from ongoing large, multicentre RCTs comparing CEA, CAS and BMT will provide clarity regarding the optimal management of patients with asymptomatic carotid artery stenosis.</p>
spellingShingle Gaba, KA
Ringleb, P
Halliday, A
Asymptomatic carotid stenosis: Intervention or best medical therapy?
title Asymptomatic carotid stenosis: Intervention or best medical therapy?
title_full Asymptomatic carotid stenosis: Intervention or best medical therapy?
title_fullStr Asymptomatic carotid stenosis: Intervention or best medical therapy?
title_full_unstemmed Asymptomatic carotid stenosis: Intervention or best medical therapy?
title_short Asymptomatic carotid stenosis: Intervention or best medical therapy?
title_sort asymptomatic carotid stenosis intervention or best medical therapy
work_keys_str_mv AT gabaka asymptomaticcarotidstenosisinterventionorbestmedicaltherapy
AT ringlebp asymptomaticcarotidstenosisinterventionorbestmedicaltherapy
AT hallidaya asymptomaticcarotidstenosisinterventionorbestmedicaltherapy