التفاصيل البيبلوغرافية
| العنوان: |
Recent advances and controversial issues in the optimal management of asymptomatic carotid stenosis |
| المؤلفون: |
Paraskevas, KI, Brown, MM, Lal, BK, Myrcha, P, Lyden, SP, Schneider, PA, Poredos, P, Mikhailidis, DP, Secemsky, EA, Musialek, P, Mansilha, A, Parikh, SA, Silvestrini, M, Lavie, CJ, Dardik, A, Blecha, M, Liapis, CD, Zeebregts, CJ, Nederkoorn, PJ, Gurevich, V, Jawien, A, Lanza, G, Gray, WA, Gupta, A, Svetlikov, AV, Fernandes e Fernandes, J, Nicolaides, AN, White, CJ, Meschia, JF, Cronenwett, JL, Schermerhorn, ML, AbuRahma, AF |
| المصدر: |
Journal of Vascular Surgery , 79 (3) pp. 695-703. (2024) |
| بيانات النشر: |
Elsevier BV |
| سنة النشر: |
2024 |
| المجموعة: |
University College London: UCL Discovery |
| مصطلحات موضوعية: |
Asymptomatic carotid stenosis, Carotid artery stenting, Carotid endarterectomy, Stroke, Transcarotid artery revascularization, Humans, Carotid Stenosis, Risk Assessment, Treatment Outcome, Endarterectomy, Carotid, Risk Factors, Endovascular Procedures, Stents, Retrospective Studies |
| الوصف: |
Objective: The optimal management of patients with asymptomatic carotid stenosis (AsxCS) is enduringly controversial. We updated our 2021 Expert Review and Position Statement, focusing on recent advances in the diagnosis and management of patients with AsxCS. Methods: A systematic review of the literature was performed up to August 1, 2023, using PubMed/PubMed Central, EMBASE and Scopus. The following keywords were used in various combinations: “asymptomatic carotid stenosis,” “carotid endarterectomy” (CEA), “carotid artery stenting” (CAS), and “transcarotid artery revascularization” (TCAR). Areas covered included (i) improvements in best medical treatment (BMT) for patients with AsxCS and declining stroke risk, (ii) technological advances in surgical/endovascular skills/techniques and outcomes, (iii) risk factors, clinical/imaging characteristics and risk prediction models for the identification of high-risk AsxCS patient subgroups, and (iv) the association between cognitive dysfunction and AsxCS. Results: BMT is essential for all patients with AsxCS, regardless of whether they will eventually be offered CEA, CAS, or TCAR. Specific patient subgroups at high risk for stroke despite BMT should be considered for a carotid revascularization procedure. These patients include those with severe (≥80%) AsxCS, transcranial Doppler-detected microemboli, plaque echolucency on Duplex ultrasound examination, silent infarcts on brain computed tomography or magnetic resonance angiography scans, decreased cerebrovascular reserve, increased size of juxtaluminal hypoechoic area, AsxCS progression, carotid plaque ulceration, and intraplaque hemorrhage. Treatment of patients with AsxCS should be individualized, taking into consideration individual patient preferences and needs, clinical and imaging characteristics, and cultural, ethnic, and social factors. Solid evidence supporting or refuting an association between AsxCS and cognitive dysfunction is lacking. Conclusions: The optimal management of patients with AsxCS should ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10188815/ |
| الاتاحة: |
https://discovery.ucl.ac.uk/id/eprint/10188815/ |
| رقم الانضمام: |
edsbas.7279356 |
| قاعدة البيانات: |
BASE |