Abstract:
:Several guidelines recommend carotid endarterectomy for patients with severe asymptomatic carotid stenosis to reduce the risk of a future cerebrovascular event, as long as the perioperative stroke/death rate is <3%. Based on improvements in best medical treatment, it was argued that currently best medical treatment alone should comprise the treatment-of-choice for asymptomatic carotid stenosis patients and that no intervention is warranted in these individuals. While it is true that best medical treatment should be used for the management of all asymptomatic carotid stenosis patients, emerging evidence suggests that best medical treatment alone may not prevent disease progression and the development of symptoms in some asymptomatic carotid stenosis patient subgroups. This article analyzes the results of two recent independent studies demonstrating that medical therapy alone may not be adequate for stroke prevention in some asymptomatic carotid stenosis patient subgroups. These results suggest that besides best medical treatment, additional carotid endarterectomy should be considered for specific asymptomatic carotid stenosis patients.
journal_name
Vascularjournal_title
Vascularauthors
Paraskevas KI,Nicolaides AN,Veith FJdoi
10.1177/1708538114560463subject
Has Abstractpub_date
2015-02-01 00:00:00pages
62-4issue
1eissn
1708-5381issn
1708-539Xpii
1708538114560463journal_volume
23pub_type
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