Endarterectomy versus stenting for stroke prevention.

Stroke and Vascular Neurology
A R Naylor

Abstract

The European Society for Vascular Surgery (ESVS) has recently prepared updated guidelines for the management of patients with symptomatic and asymptomatic atherosclerotic carotid artery disease, with specific reference to the roles of best medical therapy, carotid endarterectomy (CEA) and carotid artery stenting (CAS). In symptomatic patients, there is a drive towards performing carotid interventions as soon as possible after onset of symptoms. This is because it is now recognised that the highest risk period for recurrent stroke is the first 7-14 days after onset of symptoms. The guidelines advise that there is a role for both CEA and CAS, but the levels of evidence are slightly lower for CAS than for CEA. This is because 30-day risks of death/stroke in the randomised controlled trials (RCTs) were significantly higher than after CEA (especially in the first 7-14 days after onset of symptoms) and there are concerns that the results obtained in the RCTs may not be generalisable into routine clinical practice. In asymptomatic patients, the 2018 ESVS guidelines were the first to recommend that CEA/CAS should be targeted into a smaller cohort of patients who may be 'higher risk for stroke' on medical therapy. As with symptomatic pa...Continue Reading

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Nov 13, 2001·Journal of the American College of Cardiology·W H BrooksL Breathitt
May 12, 2004·Lancet·A HallidayUNKNOWN MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group
Oct 8, 2004·The New England Journal of Medicine·Jay S YadavUNKNOWN Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators
May 28, 2010·The New England Journal of Medicine·Thomas G BrottUNKNOWN CREST Investigators
Feb 11, 2011·Stroke; a Journal of Cerebral Circulation·Frank L SilverUNKNOWN CREST Investigators
Dec 15, 2012·Journal of Vascular Surgery·Barbara RantnerUNKNOWN Carotid Stenting Trialists' Collaboration
Dec 19, 2013·Stroke; a Journal of Cerebral Circulation·David CalvetUNKNOWN Carotid Stenting Trialists’ Collaboration
Feb 20, 2014·Pakistan Journal of Medical Sciences·Peifu WangJilai Li
Aug 2, 2014·Stroke; a Journal of Cerebral Circulation·Jean-Louis MasUNKNOWN EVA-3S Investigators
Oct 1, 2014·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A R NaylorH Sillesen
Oct 31, 2014·Stroke; a Journal of Cerebral Circulation·James F MeschiaUNKNOWN Council on Hypertension
Dec 17, 2014·The British Journal of Surgery·M KulihaD Školoudík
Mar 10, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A R NaylorT V Schroeder
Sep 9, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·K I ParaskevasA R Naylor
Oct 31, 2015·Circulation. Cardiovascular Quality and Outcomes·Sophie VincentKristian B Filion
Feb 18, 2016·The New England Journal of Medicine·Kenneth RosenfieldUNKNOWN ACT I Investigators
Feb 19, 2016·The New England Journal of Medicine·Thomas G BrottUNKNOWN CREST Investigators
Apr 18, 2016·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·H-H EcksteinUNKNOWN SPACE 2 Investigators
Aug 31, 2017·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A R NaylorM Venermo
Aug 31, 2017·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·H-H Eckstein
Dec 10, 2017·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A Ross Naylor, Jean-Baptiste Ricco

❮ Previous
Next ❯

Citations

Oct 3, 2018·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ryuichiro KajikawaHaruhiko Kishima
Jul 17, 2020·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·David M PelzManas Sharma
Jan 8, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Joomee SongGyeong-Moon Kim
Jul 25, 2019·Annals of Vascular Surgery·Marco LeopardiMarco Ventura
Mar 27, 2021·Journal of Vascular Surgery·Anne L Abbott
Apr 4, 2021·Journal of Clinical Medicine·Petroula NanaAthanasios Giannoukas

❮ Previous
Next ❯

Software Mentioned

SPACE
ICSS
EVA
CREST

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.

Related Papers

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
A R NaylorM Venermo
European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
A R Naylor, Jean-Baptiste Ricco
European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
Karl Sörelius
European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
Jürg SchmidliRamon Roca-Tey
European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
A R Naylor, Jean-Baptiste Ricco
© 2022 Meta ULC. All rights reserved