Treatment of Carotid Artery Stenosis: Medical Therapy, Surgery, or Stenting?

Overview

Journal Mayo Clin Proc

Specialty General Medicine

Date 2009 Apr 3

PMID 19339655

Citations 30

Authors

Giuseppe Lanzino

Alejandro A Rabinstein

Robert D Brown Jr

Affiliations

Soon will be listed here.

Abstract

With the aging of the general population and the availability of noninvasive imaging studies, carotid artery stenosis is a disease commonly seen in general medical practice. Differentiation between symptomatic and asymptomatic disease is critical to the treatment course because the natural history differs markedly between them. Antiplatelet therapy and aggressive treatment of vascular risk factors are the mainstays of medical therapy. Class I evidence shows that carotid endarterectomy (CEA) is effective in preventing ipsilateral ischemic events in patients with symptomatic moderate- and high-grade stenosis. The procedure is also effective in selected patients with asymptomatic stenosis, but the benefit is marginal. In the past decade, carotid angioplasty and stenting has been proposed as a valid alternative to CEA. Currently, it is unclear whether carotid angioplasty and stenting is as safe as CEA in patients with carotid artery stenosis who need invasive treatment. Large clinical trials are under way to answer this question.

Citing Articles

Assessment of Voice Quality and Vocal Cord Paralysis After Endarterectomy.

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[Open surgical treatment for carotid stenoses].

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Automatic 1-year follow-up appointment creation and reminders can improve long-term follow-up after carotid revascularization.

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Functional MRI evaluation of cognitive effects of carotid stenosis revascularization.

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