scholarly journals Comparison of long-term results of carotid endarterectomy for asymptomatic carotid artery stenosis

2018 ◽  
Vol 23 (S1) ◽  
pp. 1-7 ◽  
Author(s):  
S. Demirel ◽  
D. Böckler ◽  
M. Storck
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Long Term Results ◽  
Asymptomatic Carotid ◽  
Asymptomatic Carotid Artery Stenosis

Death associated with asymptomatic carotid artery stenosis: Long-term clinical evaluation

1993 ◽  
Vol 18 (6) ◽  
pp. 1002-1011 ◽  
Author(s):  
Ronnie M. Mintzer ◽  
Stanley N. Cohen ◽  
Robert W. Hobson ◽  
David G. Weiss
Keyword(s):  
Carotid Artery ◽  
Clinical Evaluation ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Asymptomatic Carotid ◽  
Asymptomatic Carotid Artery Stenosis

scholarly journals Asymptomatic carotid artery stenosis: time to rethink our therapeutic options?

2014 ◽  
Vol 36 (1) ◽  
pp. E2 ◽  
Author(s):  
Saul F. Morales-Valero ◽  
Giuseppe Lanzino
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Medical Therapy ◽  
Carotid Artery Stenosis ◽  
Large Scale ◽  
Artery Stenosis ◽  
Invasive Treatment ◽  
Asymptomatic Carotid ◽  
Potential Benefits ◽  
Asymptomatic Carotid Artery Stenosis

Asymptomatic carotid artery stenosis is a well-recognized risk factor for ischemic stroke, and its prevalence increases with age. In the late 1980s and in the 1990s, well-designed randomized trials established a definite advantage for carotid endarterectomy in reducing the risk of ipsilateral stroke when compared with medical therapy alone. However, medical treatment of cardiovascular disease has improved significantly over the past 2 decades, and this has, in turn, resulted in a decline of the stroke risk in patients with asymptomatic carotid artery stenosis treated medically. This improvement in medical therapy casts doubts on the effectiveness of large-scale invasive treatment in patients with asymptomatic carotid artery stenosis. Several studies have been conducted to identify possible subgroups of patients with asymptomatic stenosis who are at higher risk of stroke in order to maximize the potential benefits of invasive treatment. Ongoing large-scale trials comparing best current medical therapy to available invasive treatments, such as carotid endarterectomy and carotid artery stenting, are likely to shed some light on this debated topic in the near future. In this review, the authors summarize the current controversy surrounding the ideal management of asymptomatic carotid artery stenosis.

Carotid Artery Stenting May Be Losing the Battle against Carotid Endarterectomy for the Management of Symptomatic Carotid Artery Stenosis, But the Jury Is Still Out

Vascular ◽  
2009 ◽  
Vol 17 (4) ◽  
pp. 183-189 ◽  
Author(s):  
Kosmas I. Paraskevas ◽  
Dimitri P. Mikhailidis ◽  
Frank J. Veith
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Long Term Results ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis

Carotid artery stenting (CAS) has emerged as a potential alternative to carotid endarterectomy (CEA) for the management of carotid artery stenosis. The purpose of this article is to provide an evaluation and critical overview of the trials comparing the early and later results of CAS with CEA for symptomatic carotid stenosis. The Cochrane Controlled Trials Register, PubMed/Medline, and EMBASE databases were searched up to February 1, 2009, to identify trials comparing the long-term outcomes of CAS with CEA. The MeSH terms used were “carotid artery stenting,” “carotid endarterectomy,” “symptomatic carotid artery stenosis,” “treatment,” “clinical trial,” “randomized,” and “long-term results,” in various combinations. One single-center and three multicenter randomized studies reporting their long-term results from the comparison of CAS with CEA for symptomatic carotid stenosis were identified. All four studies independently reached the conclusion that CAS may not provide results equivalent to those of CEA for the management of symptomatic carotid stenosis. A higher incidence of recurrent stenosis and peri- and postprocedural events accounted for the inferior results reported for CAS compared with CEA. Current data from randomized studies indicate that CAS provides inferior long-term results compared with CEA for the management of symptomatic carotid artery stenosis. However, it can be argued that all of these trials were performed when both CAS equipment and CAS operators had not evolved to their current status. Given that current equipment and mature experience are required for CAS before comparing it with the current “gold standard” procedure (CEA), the results of soon-to-be reported trials (Carotid Revascularization Endarterectomy vs Stenting Trial [CREST], International Carotid Stenting Study [ICSS], or others) may alter the current impression that CAS is inferior to CEA for the treatment of symptomatic carotid stenosis.

Long-Term Results after Carotid Endarterectomy for Carotid Artery Stenosis with Contralateral Occlusion

1990 ◽  
Vol 4 (4) ◽  
pp. 323-327 ◽  
Author(s):  
Frank Vermassen ◽  
Albert Flamme ◽  
Joseph De Roose ◽  
Guyla Berszenyi ◽  
Fritz Derom
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Long Term Results

scholarly journals Carotid Endarterectomy (CEA) for Asymptomatic Carotid Artery Stenosis

2000 ◽  
Vol 28 (6) ◽  
pp. 448-453
Author(s):  
Chie YAMANAKA ◽  
Takeshi SHIMA ◽  
Masahiro NISHIDA ◽  
Kanji YAMANE ◽  
Takashi HATAYAMA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Asymptomatic Carotid ◽  
Asymptomatic Carotid Artery Stenosis

Strategies for asymptomatic carotid artery stenosis

2011 ◽  
Vol 31 (6) ◽  
pp. E9 ◽  
Author(s):  
Christopher Doe ◽  
Pinakin R. Jethwa ◽  
Chirag D. Gandhi ◽  
Charles J. Prestigiacomo
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Medical Management ◽  
Carotid Artery Stenosis ◽  
Treatment Options ◽  
Artery Stenosis ◽  
Carotid Angioplasty ◽  
Asymptomatic Carotid ◽  
The Past ◽  
Asymptomatic Carotid Artery Stenosis

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.

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