Treatment Options for Asymptomatic Carotid Artery Stenosis—Reply

JAMA ◽  
2014 ◽  
Vol 311 (5) ◽  
pp. 527
Author(s):  
Joshua A. Beckman
2011 ◽  
Vol 31 (6) ◽  
pp. E9 ◽  
Author(s):  
Christopher Doe ◽  
Pinakin R. Jethwa ◽  
Chirag D. Gandhi ◽  
Charles J. Prestigiacomo

The treatment of asymptomatic carotid artery stenosis (ACAS) has continued to evolve for the past 3 decades. With rapidly advancing technology, the results of old trials have become obsolete. While there has been little change in the efficacy of carotid endarterectomy, there have been vast improvements in both medical management and carotid angioplasty with stenting. Finding the best therapy for a given patient can therefore be difficult. In this article, the authors review the current literature regarding treatment options for ACAS and the methods available for stratifying patients who would benefit from surgical versus medical treatment.


VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 268-274
Author(s):  
Erhan Saraçoğlu ◽  
Ertan Vuruşkan ◽  
Yusuf Çekici ◽  
Salih Kiliç ◽  
Halil Ay ◽  
...  

Abstract. Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.


Author(s):  
Vicki L. Gray ◽  
Sarasijhaa K. Desikan. ◽  
Amir A. Khan ◽  
Dawn Barth ◽  
Siddhartha Sikdar ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document