Why the study?
Does the use of adjunctive pharmacologic agents improve outcomes in patients undergoing carotid endarterectomy?
Does the use of adjunctive pharmacologic agents improve outcomes in patients undergoing carotid endarterectomy?
This review highlights the lack of standardization and the need for prospective randomized trials regarding adjunctive pharmacologic agents in carotid endarterectomy.
Nonstandardized adjunctive pharmacotherapy in CEA warrants clinical caution; leaves open efficacy questions for prospective RCTs.
Although carotid endarterectomy (CEA) is now widely accepted as the surgical therapy for carotid stenosis, the role of and indications and evidence for many pharmacologic agents that are used adjunctively in the perioperative setting have not been conclusively established. Aspirin (acetylsalicylic acid) is the pharmaceutical agent that has been studied most extensively in conjunction with CEA; other than aspirin and dextran, the use of many agents before, during, and after CEA has not been standardized. Prospective randomized trials are still needed to demonstrate efficacy, predict outcome, and determine the optimal use of these medications in their adjunctive use during CEA to improve patient care and obtain optimal surgical outcomes.
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Gortler et al. (2006) studied this question.
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