How recent data have impacted the treatment of internal carotid artery stenosis

Seemant Chaturvedi; Ralph L Sacco

doi:10.1016/j.jacc.2014.12.045

How recent data have impacted the treatment of internal carotid artery stenosis

J Am Coll Cardiol. 2015 Mar 24;65(11):1134-43. doi: 10.1016/j.jacc.2014.12.045.

Authors

Seemant Chaturvedi¹, Ralph L Sacco²

Affiliations

¹ Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida; Miami Veteran Affairs Hospital, Miami, Florida.
² Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: RSacco@med.miami.edu.

PMID: 25790886
DOI: 10.1016/j.jacc.2014.12.045

Abstract

Carotid atherosclerosis accounts for approximately 10% of ischemic stroke cases. Multifaceted medical therapy reduces the risk of stroke in patients with carotid stenosis. Revascularization with endarterectomy or stenting can benefit select patients. In recent years, new information has been obtained regarding optimal selection of revascularization candidates. In addition, new concepts have been formulated regarding the relationship between carotid stenosis and vascular cognitive impairment. Finally, the declining rate of stroke with improved medical therapy has led to the launch of new clinical trials to determine the contemporary risk/benefit ratio of revascularization relative to aggressive medical therapy.

Keywords: atherosclerosis; carotid stenosis; endarterectomy; stenting; stroke prevention; stroke risk.

Publication types

Review

MeSH terms

Angioplasty*
Carotid Artery, Internal*
Carotid Stenosis / complications
Carotid Stenosis / therapy*
Endarterectomy, Carotid*
Humans
Stents*
Stroke / etiology
Stroke / prevention & control*