Carotid endarterectomy may be required in addition to best medical treatment for some patient subgroups with asymptomatic carotid stenosis.

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

Vascular

journal_title

Vascular

authors

Paraskevas KI,Nicolaides AN,Veith FJ

doi

10.1177/1708538114560463

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

62-4

issue

1

eissn

1708-5381

issn

1708-539X

pii

1708538114560463

journal_volume

23

pub_type

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