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Carotid Artery Stenosis: Medical Therapy, Surgery, and Stenting

  • Stroke (H Diener, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of the study was to update the recent information pertaining to carotid artery stenosis risk stratification and treatment.

Recent Findings

Current decision-making related to carotid artery stenosis is based on clinical trials that are outdated. Medical therapy has improved considerably in the past two decades, and this has reduced the stroke rate for both symptomatic and asymptomatic carotid stenoses. In recent community-based studies, the stroke risk with asymptomatic stenosis has been < 1% per year. For asymptomatic carotid stenosis, new trials such as CREST 2 and ECST 2 will determine whether revascularization has any benefit beyond aggressive medical management. For symptomatic patients, carotid endarterectomy is associated with a lower periprocedural stroke rate compared to carotid stenting. Age greater than 70 years is also associated with an increased risk for carotid stenting patients.

Summary

Clinicians should consider a variety of clinical and radiologic variables in reaching treatment decisions for patients with carotid stenosis. Both symptomatic and asymptomatic patients should receive optimal medical therapy.

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Author information

Authors and Affiliations

  1. St. Joseph Mercy Oakland Hospital, Pontiac, MI, USA

    Sushrut Dharmakidari & Pratik Bhattacharya

  2. Department of Neurology and Stroke Program, University of Miami Miller School of Medicine, 1120 NW 14th St., Room 1363, Miami, FL, 33136, USA

    Seemant Chaturvedi

Authors
  1. Sushrut Dharmakidari
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  2. Pratik Bhattacharya
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  3. Seemant Chaturvedi
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Corresponding author

Correspondence to Seemant Chaturvedi.

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Sushrut Dharmakidari, Pratik Bhattacharya, and Seemant Chaturvedi each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Stroke

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Dharmakidari, S., Bhattacharya, P. & Chaturvedi, S. Carotid Artery Stenosis: Medical Therapy, Surgery, and Stenting. Curr Neurol Neurosci Rep 17, 77 (2017). https://doi.org/10.1007/s11910-017-0786-2

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  • DOI: https://doi.org/10.1007/s11910-017-0786-2

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