Key result
Carotid endarterectomy is highly efficacious in carefully selected patients with symptomatic stenosis, whereas its therapeutic yield is much lower in asymptomatic stenosis, particularly in women.
Why the study?
Does carotid endarterectomy reduce the risk of ischemic stroke in patients with carotid stenosis?
Does carotid endarterectomy reduce the risk of ischemic stroke in patients with carotid stenosis?
Carotid endarterectomy provides significant benefit for symptomatic carotid stenosis but limited benefit for asymptomatic cases, especially in women.
Supports limiting carotid endarterectomy to symptomatic stenosis; leaves open its net benefit in asymptomatic patients, particularly women, with current medical therapy.
Approximately 15% of ischemic strokes are caused by extracranial carotid stenoses. Revascularization of a symptomatic stenosis is very efficacious in carefully selected patients. This review outlines criteria which help to identify those who will benefit most from carotid endarterectomy (CEA) for symptomatic stenosis. Asymptomatic carotid stenosis is a common condition in the general population over 50 years, but nonetheless associated with a low risk of ischemic stroke. Consequently, the therapeutic yield of CEA is much lower in asymptomatic stenosis and women seem not to benefit at all. In the future, specific morphological MRI features may help to identify stenoses prone to become symptomatic. In addition to their significance for stroke, it has been demonstrated that atherosclerotic lesions can be regarded as an indicator of cardiovascular morbidity which may help to identify high-risk patients for cardiovascular events.
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Koennecke (2009) conducted a review in Carotid stenosis. Carotid endarterectomy (CEA) was evaluated. Carotid endarterectomy is highly efficacious in carefully selected patients with symptomatic stenosis, whereas its therapeutic yield is much lower in asymptomatic stenosis, particularly in women.
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