Key result
Medical therapy reduces stroke risk in asymptomatic carotid stenosis, reserving CEA and CAS for high-risk plaques.
Why the study?
Advances in medical therapy have reduced event rates in asymptomatic carotid stenosis, creating a need to evaluate consensus and controversy regarding treatment selection among medical therapy, CEA, and CAS.
This review highlights the evolving landscape of asymptomatic carotid stenosis management, emphasizing the need to compare surgical and endovascular interventions with contemporary best medical therapy and to identify high-risk plaques.
May refine selection for CEA or CAS in asymptomatic carotid stenosis; leaves open updated trials versus contemporary medical therapy.
近年, 内科的治療の進歩により最良の内科治療を実施した場合の無症候性頚動脈狭窄症の発症率は低下している. CEAは手術後の同側脳梗塞の予防をするためのgold standardである. またCASもデバイスの進歩により課題であった遠位塞栓が減少してCEAに匹敵している. 治療選択は時代に沿った内科治療の成績との比較が行われるべきである. われわれ脳神経外科医はプラーク性状やプラークの形態学的特徴を理解し, 脳梗塞発症のハイリスク例を抽出することが今後の課題となる. 本論文では無症候性頚動脈狭窄症におけるconsensus and controversyについて述べる.
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Daina Kashiwazaki (2024) conducted a review in Asymptomatic carotid stenosis. Carotid endarterectomy, carotid artery stenting, and medical therapy was evaluated.
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