TY - JOUR
TI - ESVS Guidelines. Invasive Treatment for Carotid Stenosis: Indications,
Techniques
AU - Liapis, C. D.
AU - Bell, P. R. F.
AU - Mikhailidis, D.
AU - Sivenius, J.
AU - and Nicolaides, A.
AU - Fernandes e Fernandes, J.
AU - Biasi, G. and
AU - Norgren, L.
AU - ESVS Guidelines Collaborators
JO - European Journal of Vascular and Endovascular Surgery
PY - 2009
VL - 37
TODO - 1
SP - S1-S19
PB - W B SAUNDERS CO LTD
SN - 1078-5884, 1532-2165
TODO - 10.1016/j.ejvs.2008.11.006
TODO - Carotid stenosis; Treatment; Guidelines; Angioplasty; Stenting;
Endarterectomy
TODO - The European Society for Vascular Surgery brought together a group of
experts in the field of carotid artery disease to produce updated
guidelines for the invasive treatment of carotid disease. The
recommendations were rated according to the Level of evidence. Carotid
endarterectomy (CEA) is recommended in symptomatic patients with > 50%
stenosis if the perioperative stroke/death rate is < 6% [A],
preferably within 2 weeks of the patient’s Last symptoms [A]. CEA is
also recommended in asymptomatic men < 75 years old with 70-99%
stenosis if the perioperative stroke/death risk is < 3% [A]. The
benefit from CEA in asymptomatic women is significantly less than in men
[A]. CEA should therefore be considered only in younger, fit women
[A]. Carotid patch angioplasty is preferable to primary closure [A].
Aspirin at a dose of 75-325 mg daily and statins should be given before,
during and following CEA. [A] Carotid artery stenting (CAS) should be
performed only in high-risk for CEA patients, in high-volume centres
with documented tow peri-operative stroke and death rates or inside a
randomized controlled trial [C]. CAS should be performed under dual
antiplatelet treatment with aspirin and clopidogrel [A]. Carotid
protection devices are probably of benefit [C]. (C) 2008 European
Society for Vascular Surgery. Published by Elsevier Ltd. All rights
reserved.
ER -