Selection of treatment for patients with carotid artery disease: medication, carotid endarterectomy, or carotid artery stenting.
| Autor: | Bosiers, Marc, Peeters, Patrick, Deloose, Koen, Verbist, Jürgen, Sprouse II, L. Richard, Verbist, Jürgen, Sprouse, Richard L 2nd |
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| Předmět: |
ATHEROSCLEROSIS
CAROTID artery CEREBROVASCULAR disease THERAPEUTICS ARTERIOSCLEROSIS STROKE prevention STROKE-related mortality ALGORITHMS BLOOD vessel prosthesis COMPARATIVE studies RESEARCH methodology MEDICAL cooperation RESEARCH SURGICAL stents SURVIVAL TIME EVALUATION research CAROTID artery stenosis TREATMENT effectiveness PATIENT selection CAROTID endarterectomy |
| Zdroj: | Vascular; May/Apr2005, Vol. 13 Issue 2, p92-97, 6p, 3 Diagrams, 1 Chart |
| Abstrakt: | Patients presenting with atherosclerosis of the extracranial carotid arteries may be offered carotid endarterectomy (CEA), carotid artery stenting (CAS), or medical therapy to reduce their risk of stroke. In many cases, the choice between treatment modalities remains controversial. An algorithm based on patients' neurologic symptoms, comorbidities, limiting factors for CAS and CEA, and personal preferences was developed to determine the optimal treatment in each case. This algorithm was then employed to determine therapy in 308 consecutive patients presenting to a single institution during one calendar year. Ninety-five (30.8%) patients presented with an asymptomatic carotid stenosis of more than 80% and 213 (69.2%) with a symptomatic stenosis of more than 50%. According to our algorithm, 59 (62.1%) of the 95 asymptomatic patients received CAS, 20 (21.1%) received CEA, and 16 (16.8%) received medical therapy. All symptomatic patients underwent intervention; 153 (71.8%) were treated with CAS and 60 (28.2%) with CEA. Combined 30-day stroke and death rates after CAS were 1.7% in asymptomatic patients and 2.6% in symptomatic patients. After CEA, these rates were 0% and 3.3%, respectively. Careful selection of treatment modality according to predetermined criteria can result in improved outcomes. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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