Prognosis and therapy of carotid stenoses--a review of results of current studies
Carotid stenoses as either a source of artery-to-artery emboli or a hemodynamic process of reduced brain perfusion can lead to transient ischemic attacks and brain infarcts. Although the prognosis of both symptomatic and asymptomatic patients correlates with the degree of the lumen narrowing and the progression of the atherosclerotic vessel process, the risk of a new cerebral ischemia is 5 to 15 times greater in symptomatic patients than in those whose vessel process has remained silent. Correspondingly, multicenter studies have shown that surgical treatment of high degree carotid stenosis under certain conditions as secondary prevention is warranted while until now no indication for carotid endarterectomy in the asymptomatic stage can be verified. An exact analysis of the studies' protocols and the results of multicenter examinations show that detailed patient selection is a prerequisite for both conservative and surgical treatment of a patient at risk.