Asymptomatic carotid artery patients with

There are data to suggest that patients with asymptomatic carotid artery stenosis of 60% or more benefit from carotid endarterectomy if it is performed by a qualified surgeon with low complication rates (less than 3%). At this time, there is considerable controversy over how this information can be applied to clinical practice. A current review recommends considering carotid endarterectomy in patients with carotid artery stenosis... [Pg.170]

Schroeder T (1988). Hemodynamic significance of internal carotid artery disease. Acta Neurologica Scandinavica 77 353-372 Schroeder T, Sillesen H, Sorensen O et al. (1987). Cerebral hyperfusion following carotid endarterectomy. Journal of Neurosurgery 66 824-829 Shaw DA, Venables GS, Cartlidge NEF et al. (1984). Carotid endarterectomy in patients with transient cerebral ischaemia. Journal of Neurological Sciences 64 45-53 Silvestrini M, Vernieri F, Pasqualetti P et al. (2000). Impaired cerebral vasoreactivity and risk of stroke in patients with asymptomatic carotid artery stenosis. [Pg.302]

Who Should be Considered for Screening for Asymptomatic CAS 166 Carotid Revascularization for Patients With Asymptomatic Carotid Artery Stenosis ... [Pg.165]

The Controversy 167 Risk Stratification of Patients With Asymptomatic CAS 168 Carotid Artrey Stenting for Asymptomatic Carotid Artery Disease 170 Summary 174 References 176... [Pg.165]

CAROTID REVASCULARIZATION FOR PATIENTS WITH ASYMPTOMATIC CAROTID ARTERY STENOSIS THE CONTROVERSY... [Pg.167]

FIGURE 9.1 Triage of patients with asymptomatic carotid artery stenosis to carotid endarterectomy (CEA) versus carotid artery stenting. (Adapted from Ref. 8, with permission.)... [Pg.171]

Silvestrini M, Vernieri F, Pasqualetti P, et al. Impaired cerebral vasoreactivity and risk of stroke in patients with asymptomatic carotid artery stenosis. JAMA 2000 283 2122-7. [Pg.177]

Roubin GS, New G, Iyer SS et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis a 5-year prospective analysis. Circulation 2001 Jan 30 103(4) 532-7. [Pg.177]

Mitsias P, Levine SR (1994). Large cerebral vessel occlusive disease in systemic lupus erythematosus. Neurology 44 385-393 Molloy J, Markus HS (1999). Asymptomatic embolization predicts stroke and TIA risk in patients with carotid artery stenosis. Stroke 30 1440-1443... [Pg.87]

Asymptomatic Carotid Atherosclerosis Study Group (1995). Carotid endarterectomy for patients with asymptomatic internal carotid artery stenosis. Journal of the American Medical Association 273 1421-1428 Barnett HJ, Taylor DW, Ehasziw M etal. (1998). The final results of the NASCET trial. New England Journal of Medicine 339 1415-1425 Cardiac Arrhythmia Suppression Trial (CAST) Investigators (1989). Preliminary report effect of encainide and flecainide on mortality in a randomised trial of arrhythmia suppression after myocardial infarction. New England Journal of Medicine 321 406-412 Charleson ME, Horwitz RI (1984). Applying results of randomised trials to clinical practice impact of losses before randomisation. British Medical Journal 289 1281-1284... [Pg.237]

The surgical removal of atheromatous plaque from within the carotid artery is termed carotid endarterectomy. The operation was first performed in an attempt to improve the flow of blood to the brain, although no systematic attempt was made to assess the risks and benefits of the procedure. Subsequently, randomized trials were performed in patients with a history of recent symptomatic stroke, and also in those with asymptomatic disease, to determine whether the operation was beneficial and, if so, what the predictors of benefit would be. As a result of these trials, carotid endarterectomy has been proven to be an effective treatment for the secondary prevention of stroke in selected patients. [Pg.290]

Inzitari D, Eliasziw M, Gates P for the North American Symptomatic Carotid Endarterectomy Trial Group (2000). The causes and risk of stroke in patients with asymptomatic internal-carotid-artery stenosis. New England Journal of Medicine 342 1693-1700... [Pg.328]

This concern extends to carotid artery stenting. Although carotid artery stenting in patients with asymptomatic CAS can be performed by experienced operators with a low complication rate, the procedure can be associated with high complication rate if performed by inexperienced operators, particularly in older patients with complex anatomy (24). In any case, institution-specific assessment of the risk of carotid intervention, endarterectomy, or stenting should be a prime consideration in clinical decision making regarding carotid revascularization in patients with asymptomatic CAS. [Pg.168]

FIGURE 9.2 Type 3 aortic arch in a high-surgical-risk patient with asymptomatic severe left internal carotid artery stenosis. [Pg.172]

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