Key result
Review details optimal peri-operative antiplatelet, statin, and blood pressure management for carotid endarterectomy.
Why the study?
Optimal medical therapy during carotid endarterectomy has never been standardized and varies within and across health systems.
This review provides a personal perspective on the components of optimal peri-operative medical therapy for patients undergoing carotid endarterectomy.
Answers are grounded in this paper and cite their sources.
Standardization of peri-operative medical therapy for CEA remains elusive; leaves open the need for prospective trials to define optimal regimens.
An important component in managing patients undergoing carotid endarterectomy (CEA) is ensuring that each receives appropriate peri-operative 'best medical therapy' as well as the assurance of a safely performed procedure. What exactly constitutes optimal medical therapy will, of course, vary both within and across health systems and has never been standardised. Accordingly, the suggestions made in this review reflect the author's personal practice and are based upon a review of the currently available evidence. The principal themes are choice of antiplatelet therapy, statin therapy, blood pressure control, choice of intra-operative heparin, the use of targeted (selective) Dextran 40 therapy postoperatively and guidelines for managing post-operative hypertension.
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A.R. Naylor (2009) conducted a review in Patients undergoing carotid endarterectomy (CEA). Optimal medical therapy (antiplatelet, statin, blood pressure control, heparin, Dextran 40) was evaluated. This review outlines personal practice suggestions for optimal peri-operative medical therapy during carotid endarterectomy, including antiplatelets, statins, and blood pressure control.
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