Key result
Current evidence for periprocedural pharmacologic agents in carotid artery stenting is lacking, though dual-antiplatelet therapy with aspirin 325 mg and clopidogrel 75 mg daily is commonly used.
The review highlights the lack of standardized evidence for periprocedural pharmacologic agents in carotid artery stenting, emphasizing the need for large prospective studies.
Evidence for periprocedural agents in carotid stenting remains insufficient; leaves open optimal regimens pending large prospective trials.
Carotid artery stenting (CAS) is a widely accepted alternative for patients at high risk for carotid endarterectomy (CEA). However, the role, indications, and evidence for many pharmacologic agents that are used adjunctively in the periprocedural setting have not been established. Several drugs are commonly used before, during, and after CAS, but their uses have not been standardized. Large prospective cohort studies with good validity or randomized trials are needed to demonstrate efficacy, predict outcome, and determine the optimal use of these medications in patients undergoing CAS to improve patient care and obtain optimal outcomes. Several conclusions can be made: (1) dual-antiplatelet therapy (aspirin and clopidogrel) is commonly used for CAS; (2) the most commonly used regimen is aspirin 325 mg and clopidogrel 75 mg per day, but the optimal time of therapy is unknown; and (3) the dose and regimen of other agents used for CAS are not established.
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Gortler et al. (2008) conducted a review in Patients undergoing carotid artery stenting. Periprocedural drug therapy (dual-antiplatelet therapy) was evaluated. Current evidence for periprocedural pharmacologic agents in carotid artery stenting is lacking, though dual-antiplatelet therapy with aspirin 325 mg and clopidogrel 75 mg daily is commonly used.
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