Carotid Artery Stenosis: Medical Therapy, Surgery, and Stenting

Sushrut Dharmakidari, Pratik Bhattacharya, Seemant Chaturvedi

Research output: Contribution to journalReview article

11 Scopus citations

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 Recent Findings: Current decision-making related to carotid artery stenosis is based on clinical trials that are outdated.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 languageEnglish (US)
Article number77
JournalCurrent Neurology and Neuroscience Reports
Volume17
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Carotid endarterectomy
  • Carotid stenosis
  • Carotid stenting
  • Statins

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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