Abstract
Carotid stenosis is an important cause of ischemic stroke. About 10–15% of patients with carotid territory strokes and transient ischemic attacks (TIA) have a carotid stenosis >50%. On best medical treatment, these patients have a high risk of further, potentially disabling, cerebral ischemic events of up to 10% in the first week, and 15% in the first month after the initial event. Urgent treatment of the carotid stenosis to prevent recurrent strokes is therefore mandatory.
Keywords
- Carotid Stenosis
- Symptomatic Carotid
- Secondary Stroke Prevention
- Transient Ischemic Attack
- Asymptomatic Carotid Stenosis
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Adams HP, Adams RJ, Brott T, del Zoppo GJ, Furlan A, Goldstein LB, et al. Guidelines for the early management of patients with ischemic stroke. A scientific statement from the Stroke Council of the American Stroke Association. Stroke. 2003;34:1056–83.
Adams HP, Adams RJ, Del Zoppo GJ, Goldstein LB. Guidelines for the early management of patients with ischemic stroke. 2005 guidelines update. A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke. 2005;36:916–23 (The last two papers give a good overview over current recommended management of ischemic stroke).
Arnold M, Fischer U, Schroth G, Nedeltchev K, Isenegger J, Remonda L, et al. Intra-arterial thrombolysis of acute Iatrogenic intracranial arterial occlusion attributable to neuroendovascular procedures or coronary angiography. Stroke. 2008;39:1491–5 (i.a. thrombolysis after angiography associated stroke may be helpful).
Chambers BR, Donnan G. Carotid endarterectomy for asymptomatic carotid stenosis. Cochrane Database Syst Rev 2005, 4. Art. No. CD001923. (Cochrane review of carotid endarterectomy in asymptomatic stenosis.)
Dangas G. Editorial comment–hypotension after carotid revascularization. Stroke. 2003;34:2581–2 (Editorial to Reference 7).
Howell SJ. Carotid endarterectomy. Br J Anaesth. 2007;99:119–31 (Review of carotid endarterectomy with a specific view to anesthetic problems).
International Carotid Stenting Study investigators. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid STenting Study): an interim analysis of a randomised controlled trial.
Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG. CREST Investigators. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke. 2010;41(10 Suppl):S31–4.
McKevitt FM, Sivaguru A, Venables GS, et al. Effect of treatment of carotid artery stenosis on blood pressure: a comparison of hemodynamic disturbances after carotid endarterectomy and endovascular treatment. Stroke. 2003;34:2576–82 (Trial investigating cardiovascular changes after CEA and CAS. Associated editorial with a good review in Dangas G. See 2 references above).
Ricotta JJ, Malgor RD. A review of the trials comparing carotid endarterectomy and carotid angioplasty and stenting. Perspect Vasc Surg Endovasc Ther. 2008;20:299–308 (Review of the currently available trials comparing carotid endarterectomy and stenting).
Rothwell PM, Eliasziw M, Gutnikov SA, et al. Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis. Lancet. 2003;361:107–16 (Individual patient data meta-analysis of the carotid endarterectomy trials for symptomatic stenosis).
van Mook WNKA, Rennenberg RJMW, Schurink GW, van Oostenbrugge RJ, Mess WH, Hofman PAM, et al. Cerebral hyperperfusion syndrome. Lancet Neurol. 2005;4:877–88. Good review of cerebral hyperperfusion syndrome.
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Schulz, U., Rothwell, P. (2012). Perioperative Challenges During Carotid Artery Revascularization. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09562-2_35
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DOI: https://doi.org/10.1007/978-0-387-09562-2_35
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