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 language | English (US) |
|---|---|
| Pages (from-to) | 323-334 |
| Number of pages | 12 |
| Journal | CONTINUUM Lifelong Learning in Neurology |
| Volume | 20 |
| Issue number | 2 Cerebrovascular Disease |
| DOIs | |
| State | Published - Apr 1 2014 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
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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 journal › Article
}
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.
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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 -