The current management of carotid atherosclerotic disease: who, when and how?

• Published in: Interactive cardiovascular and thoracic surgery Vol. 16; no. 3; pp. 339 - 346
• Main Authors: Ritter, Jens C., Tyrrell, Mark R.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2013
• Series: Editor's choice
• Subjects: Amaurosis Fugax - etiology; Amaurosis Fugax - prevention & control; Angioplasty - adverse effects; Angioplasty - instrumentation; Asymptomatic Diseases; Cardiovascular Agents - adverse effects; Cardiovascular Agents - therapeutic use; Carotid Stenosis - complications; Carotid Stenosis - diagnosis; Carotid Stenosis - physiopathology; Carotid Stenosis - therapy; Endarterectomy, Carotid - adverse effects; Hemodynamics; Humans; Ischemic Attack, Transient - etiology; Ischemic Attack, Transient - physiopathology; Ischemic Attack, Transient - prevention & control; Patient Selection; Predictive Value of Tests; Risk Assessment; Risk Factors; Risk Reduction Behavior; Severity of Illness Index; State-of-the-Art; Stents; Stroke - etiology; Stroke - physiopathology; Stroke - prevention & control; Treatment Outcome; Cardiovascular disease; Stroke; Carotid artery disease; Carotid endarterectomy
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivs453

Ischaemic stroke represents a major health hazard in the western world, which has a severe impact on society and the health-care system. Roughly, 10% of all first ischaemic strokes can be attributed to significant atherosclerotic disease of the carotid arteries. Correct management of these lesions is essential in the prevention and treatment of carotid disease-related ischaemic events. The close relationship between diagnosis and medical and surgical management makes it necessary that all involved physicians and surgeons have profound knowledge of management strategies beyond their specific speciality. Continuous improvement in pharmacological therapy and operative techniques as well as frequently changing guidelines represent a constant challenge for the individual health-care professional. This review gives a thorough outline of the up-to-date evidence-based management of carotid artery disease and discusses its current controversies.