Why the study?
Extracranial atherosclerotic disease causes up to 25% of ischemic strokes, and an updated review of evolving medical and interventional management evidence and guidelines is needed.
Do interventional treatments (carotid artery stenting or carotid endarterectomy) combined with optimal medical therapy improve stroke prevention in patients with carotid artery stenosis compared to medical therapy alone or each other?
Do interventional treatments (carotid artery stenting or carotid endarterectomy) combined with optimal medical therapy improve stroke prevention in patients with carotid artery stenosis compared to medical therapy alone or each other?
This review highlights that while optimal medical therapy is essential for all patients with carotid artery stenosis, CEA and CAS remain important interventions for symptomatic and high-risk asymptomatic patients, with CEA generally preferred in patients over 70 years old.
Answers are grounded in this paper and cite their sources.
Advances in ECAD management may lower stroke risk; leaves open refined risk stratification for CEA versus CAS.
Stroke is a leading cause of adult mortality and disability worldwide. Extracranial atherosclerotic disease (ECAD), primarily, carotid artery stenosis, accounts for approximately 18%-25% of ischaemic stroke. Recent advances in neuroimaging, medical therapy and interventional management have led to A significant reduction of stroke from carotid artery stenosis. The current treatment of ECAD includes optimal medical therapy, carotid endarterectomy (CEA) and carotid artery stenting (CAS). The selection of treatments depends on symptomatic status, severity of stenosis, individual factors, efficacy and risk of complications. The aim of this paper is to review current evidence and guidelines on the management of carotid artery stenosis, including the comparison of medical and interventional therapy (CAS and CEA), as well as future directions.
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Zhu et al. (2019) studied this question.
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