Evolving treatment strategies for carotid artery stenosis

被引:0
作者
Van Stavern R.B. [1 ]
Chaturvedi S. [1 ]
机构
[1] Department of Neurology, Wayne State University, Detroit, MI 48201
关键词
Stroke Prevention; Carotid Endarterectomy; Carotid Stenosis; Carotid Artery Stenosis; Absolute Risk Reduction;
D O I
10.1007/s11936-004-0038-z
中图分类号
学科分类号
摘要
Internal carotid artery stenosis is an important cause of ischemic stroke. Treatment decisions frequently center on whether the patient is symptomatic or asymptomatic. For recently symptomatic patients with severe stenosis (70% to 99%) and low to medium surgical risk, carotid endarterectomy (CEA) is extremely useful for stroke prevention. CEA is moderately useful for patients with 50% to 69% symptomatic stenosis and is not indicated for patients with symptomatic stenosis of less than 50%. CEA may be useful for select patients with severe asymptomatic stenosis (80% to 99%) but only if the surgical complication is kept below the 3% level. Carotid stenting is an emerging option for the future but is still experimental. In addition to carotid intervention, patients with carotid stenosis should receive aggressive risk factor management, including treatment with antiplatelet agents and statins. Copyright © 2004 by Current Science Inc.
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页码:105 / 112
页数:7
相关论文
共 45 条
[1]  
Heart Disease and Stroke Statistics Update-2003, (2002)
[2]  
Wolf P.A., D'Angostino R.B., Epidemiology of stroke, Stroke: Pathophysiology, Diagnosis, and Management, pp. 3-28, (1998)
[3]  
Robertson J.T., Carotid endarterectomy: A saga of clinical science, personalities, and evolving technology, Stroke, 29, pp. 2435-2441, (1998)
[4]  
Estol C.J., Dr. C. Miller Fisher and the history of carotid artery disease, Stroke, 27, pp. 559-566, (1996)
[5]  
Wolf P.A., Grotta J.C., Cerebrovascular disease, Circulation, 102, (2000)
[6]  
The final results of the NASCET trial, N. Engl. J. Med., 339, pp. 1415-1425, (1998)
[7]  
Carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis, JAMA, 273, pp. 1421-1428, (1995)
[8]  
Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators, N. Engl. J. Med., 325, pp. 445-453, (1991)
[9]  
Streifler J.Y., Eliasziw M., Benavente O.R., Et al., The risk of stroke in patients with first-ever retinal vs. hemispheric transient ischemic attacks and high-grade carotid stenosis, Arch. Neurol., 52, pp. 246-249, (1995)
[10]  
Eliasziw M., Streifler J.Y., Fox A.J., Et al., Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis, Stroke, 25, pp. 304-308, (1994)