Abstract
Purpose of Review: The purpose of the study was to update the recent information pertaining to carotid artery stenosis risk stratification and treatment. Recent Findings: Current decision-making related to carotid artery stenosis is based on clinical trials that are outdated. Medical therapy has improved considerably in the past two decades, and this has reduced the stroke rate for both symptomatic and asymptomatic carotid stenoses. In recent community-based studies, the stroke risk with asymptomatic stenosis has been < 1% per year. For asymptomatic carotid stenosis, new trials such as CREST 2 and ECST 2 will determine whether revascularization has any benefit beyond aggressive medical management. For symptomatic patients, carotid endarterectomy is associated with a lower periprocedural stroke rate compared to carotid stenting. Age greater than 70 years is also associated with an increased risk for carotid stenting patients. Summary: Clinicians should consider a variety of clinical and radiologic variables in reaching treatment decisions for patients with carotid stenosis. Both symptomatic and asymptomatic patients should receive optimal medical therapy.
| Original language | English (US) |
|---|---|
| Article number | 77 |
| Journal | Current Neurology and Neuroscience Reports |
| Volume | 17 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2017 |
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Keywords
- Carotid endarterectomy
- Carotid stenosis
- Carotid stenting
- Statins
ASJC Scopus subject areas
- Neuroscience(all)
- Clinical Neurology
Cite this
Carotid Artery Stenosis : Medical Therapy, Surgery, and Stenting. / Dharmakidari, Sushrut; Bhattacharya, Pratik; Chaturvedi, Seemant.
In: Current Neurology and Neuroscience Reports, Vol. 17, No. 10, 77, 01.10.2017.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Carotid Artery Stenosis
T2 - Medical Therapy, Surgery, and Stenting
AU - Dharmakidari, Sushrut
AU - Bhattacharya, Pratik
AU - Chaturvedi, Seemant
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose of Review: The purpose of the study was to update the recent information pertaining to carotid artery stenosis risk stratification and treatment. Recent Findings: Current decision-making related to carotid artery stenosis is based on clinical trials that are outdated. Medical therapy has improved considerably in the past two decades, and this has reduced the stroke rate for both symptomatic and asymptomatic carotid stenoses. In recent community-based studies, the stroke risk with asymptomatic stenosis has been < 1% per year. For asymptomatic carotid stenosis, new trials such as CREST 2 and ECST 2 will determine whether revascularization has any benefit beyond aggressive medical management. For symptomatic patients, carotid endarterectomy is associated with a lower periprocedural stroke rate compared to carotid stenting. Age greater than 70 years is also associated with an increased risk for carotid stenting patients. Summary: Clinicians should consider a variety of clinical and radiologic variables in reaching treatment decisions for patients with carotid stenosis. Both symptomatic and asymptomatic patients should receive optimal medical therapy.
AB - Purpose of Review: The purpose of the study was to update the recent information pertaining to carotid artery stenosis risk stratification and treatment. Recent Findings: Current decision-making related to carotid artery stenosis is based on clinical trials that are outdated. Medical therapy has improved considerably in the past two decades, and this has reduced the stroke rate for both symptomatic and asymptomatic carotid stenoses. In recent community-based studies, the stroke risk with asymptomatic stenosis has been < 1% per year. For asymptomatic carotid stenosis, new trials such as CREST 2 and ECST 2 will determine whether revascularization has any benefit beyond aggressive medical management. For symptomatic patients, carotid endarterectomy is associated with a lower periprocedural stroke rate compared to carotid stenting. Age greater than 70 years is also associated with an increased risk for carotid stenting patients. Summary: Clinicians should consider a variety of clinical and radiologic variables in reaching treatment decisions for patients with carotid stenosis. Both symptomatic and asymptomatic patients should receive optimal medical therapy.
KW - Carotid endarterectomy
KW - Carotid stenosis
KW - Carotid stenting
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85027868930&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85027868930&partnerID=8YFLogxK
U2 - 10.1007/s11910-017-0786-2
DO - 10.1007/s11910-017-0786-2
M3 - Review article
C2 - 28825185
AN - SCOPUS:85027868930
VL - 17
JO - Current Neurology and Neuroscience Reports
JF - Current Neurology and Neuroscience Reports
SN - 1528-4042
IS - 10
M1 - 77
ER -