Large artery atherosclerosis: carotid stenosis, vertebral artery disease, and intracranial atherosclerosis

Seemant Chaturvedi, Pratik Bhattacharya

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Large artery atherosclerosis is an important cause of ischemic stroke. Recent randomized clinical trials have helped clarify the treatment options for conditions such as carotid stenosis and intracranial atherosclerosis. This review outlines the primary findings of these trials and provides current recommendations for treatment.

RECENT FINDINGS: Carotid revascularization is preferred in patients with severe symptomatic carotid stenosis. Carotid endarterectomy achieves lower rates of stroke or death than carotid artery stenting. The risk of stroke or death with stenting is higher among older patients and women. Intensive medical therapy achieves low stroke and death rates in asymptomatic stenosis. Medical therapy and treatment of atherosclerotic risk factors are the mainstay of therapy for intracranial atherosclerosis, and medical therapy is recommended for patients with vertebral artery origin atherosclerosis.

SUMMARY: Contemporary medical therapy is paramount in large artery atherosclerosis. Patient demographics, comorbidities, and the periprocedural risks of stroke and death should be carefully weighed while choosing a revascularization procedure for carotid stenosis.

Original languageEnglish (US)
Pages (from-to)323-334
Number of pages12
JournalCONTINUUM Lifelong Learning in Neurology
Volume20
Issue number2 Cerebrovascular Disease
DOIs
StatePublished - Apr 1 2014
Externally publishedYes

Fingerprint

Intracranial Arteriosclerosis
Vertebral Artery
Carotid Stenosis
Atherosclerosis
Stroke
Therapeutics
Arteries
Carotid Artery Diseases
Carotid Endarterectomy
Carotid Arteries
Comorbidity
Pathologic Constriction
Randomized Controlled Trials
Demography
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Large artery atherosclerosis : carotid stenosis, vertebral artery disease, and intracranial atherosclerosis. / Chaturvedi, Seemant; Bhattacharya, Pratik.

In: CONTINUUM Lifelong Learning in Neurology, Vol. 20, No. 2 Cerebrovascular Disease, 01.04.2014, p. 323-334.

Research output: Contribution to journalArticle

@article{d850be6b9ad74e6f96452f19e09f5121,
title = "Large artery atherosclerosis: carotid stenosis, vertebral artery disease, and intracranial atherosclerosis",
abstract = "PURPOSE OF REVIEW: Large artery atherosclerosis is an important cause of ischemic stroke. Recent randomized clinical trials have helped clarify the treatment options for conditions such as carotid stenosis and intracranial atherosclerosis. This review outlines the primary findings of these trials and provides current recommendations for treatment.RECENT FINDINGS: Carotid revascularization is preferred in patients with severe symptomatic carotid stenosis. Carotid endarterectomy achieves lower rates of stroke or death than carotid artery stenting. The risk of stroke or death with stenting is higher among older patients and women. Intensive medical therapy achieves low stroke and death rates in asymptomatic stenosis. Medical therapy and treatment of atherosclerotic risk factors are the mainstay of therapy for intracranial atherosclerosis, and medical therapy is recommended for patients with vertebral artery origin atherosclerosis.SUMMARY: Contemporary medical therapy is paramount in large artery atherosclerosis. Patient demographics, comorbidities, and the periprocedural risks of stroke and death should be carefully weighed while choosing a revascularization procedure for carotid stenosis.",
author = "Seemant Chaturvedi and Pratik Bhattacharya",
year = "2014",
month = "4",
day = "1",
doi = "10.1212/01.CON.0000446104.90043.a5",
language = "English (US)",
volume = "20",
pages = "323--334",
journal = "CONTINUUM Lifelong Learning in Neurology",
issn = "1080-2371",
publisher = "Lippincott Williams and Wilkins",
number = "2 Cerebrovascular Disease",

}

TY - JOUR

T1 - Large artery atherosclerosis

T2 - carotid stenosis, vertebral artery disease, and intracranial atherosclerosis

AU - Chaturvedi, Seemant

AU - Bhattacharya, Pratik

PY - 2014/4/1

Y1 - 2014/4/1

N2 - PURPOSE OF REVIEW: Large artery atherosclerosis is an important cause of ischemic stroke. Recent randomized clinical trials have helped clarify the treatment options for conditions such as carotid stenosis and intracranial atherosclerosis. This review outlines the primary findings of these trials and provides current recommendations for treatment.RECENT FINDINGS: Carotid revascularization is preferred in patients with severe symptomatic carotid stenosis. Carotid endarterectomy achieves lower rates of stroke or death than carotid artery stenting. The risk of stroke or death with stenting is higher among older patients and women. Intensive medical therapy achieves low stroke and death rates in asymptomatic stenosis. Medical therapy and treatment of atherosclerotic risk factors are the mainstay of therapy for intracranial atherosclerosis, and medical therapy is recommended for patients with vertebral artery origin atherosclerosis.SUMMARY: Contemporary medical therapy is paramount in large artery atherosclerosis. Patient demographics, comorbidities, and the periprocedural risks of stroke and death should be carefully weighed while choosing a revascularization procedure for carotid stenosis.

AB - PURPOSE OF REVIEW: Large artery atherosclerosis is an important cause of ischemic stroke. Recent randomized clinical trials have helped clarify the treatment options for conditions such as carotid stenosis and intracranial atherosclerosis. This review outlines the primary findings of these trials and provides current recommendations for treatment.RECENT FINDINGS: Carotid revascularization is preferred in patients with severe symptomatic carotid stenosis. Carotid endarterectomy achieves lower rates of stroke or death than carotid artery stenting. The risk of stroke or death with stenting is higher among older patients and women. Intensive medical therapy achieves low stroke and death rates in asymptomatic stenosis. Medical therapy and treatment of atherosclerotic risk factors are the mainstay of therapy for intracranial atherosclerosis, and medical therapy is recommended for patients with vertebral artery origin atherosclerosis.SUMMARY: Contemporary medical therapy is paramount in large artery atherosclerosis. Patient demographics, comorbidities, and the periprocedural risks of stroke and death should be carefully weighed while choosing a revascularization procedure for carotid stenosis.

UR - http://www.scopus.com/inward/record.url?scp=84921425118&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921425118&partnerID=8YFLogxK

U2 - 10.1212/01.CON.0000446104.90043.a5

DO - 10.1212/01.CON.0000446104.90043.a5

M3 - Article

C2 - 24699484

AN - SCOPUS:84898640810

VL - 20

SP - 323

EP - 334

JO - CONTINUUM Lifelong Learning in Neurology

JF - CONTINUUM Lifelong Learning in Neurology

SN - 1080-2371

IS - 2 Cerebrovascular Disease

ER -