Carotid stenting in asymptomatic patients: how to identify patients without symptoms and at high risk for neurologic events.
J Cardiovasc Surg (Torino)
; 54(1): 55-9, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-23296416
ABSTRACT
During the last 20 years, asymptomatic patients with high-grade carotid stenosis have been treated with carotid endarterectomy and more recently with carotid artery stenting in order to prevent stroke. New, best medical treatment including statins, beta-blockers, antiplatelet therapies, and better diabetes and blood pressure control might reduce the incidence of stroke in this patient population making invasive treatment unnecessary. However, patients with asymptomatic carotid stenosis cannot be considered a homogenous population, and therefore, the therapeutic approach should take into consideration a subgroup of patients with greater risk of cerebrovascular event. Unfortunately, these risk factors are not well categorized thus far, although multiple publications have addressed each one of these factors individually. Recognizing these risk factors is essential for optimizing surveillance and therapeutic approach based on individual risk. The purpose of this article is to review such factors, including patient history, presence of embolic signals on Transcranial Doppler ultrasound, and plaque morphology. These factors should identify high risk asymptomatic individuals who could benefit from carotid stenting or carotid endarterectomy.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Artérias Carótidas
/
Stents
/
Endarterectomia das Carótidas
/
Estenose das Carótidas
/
Medição de Risco
/
Implante de Prótese Vascular
/
Acidente Vascular Cerebral
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Cardiovasc Surg (Torino)
Ano de publicação:
2013
Tipo de documento:
Article