Management of The Carotid Artery Stenosis in Asymptomatic Patients.
Journal
Revista portuguesa de cirurgia cardio-toracica e vascular : orgao oficial da Sociedade Portuguesa de Cirurgia Cardio-Toracica e Vascular
ISSN: 0873-7215
Titre abrégé: Rev Port Cir Cardiotorac Vasc
Pays: Portugal
ID NLM: 101154446
Informations de publication
Date de publication:
Historique:
received:
18
09
2020
entrez:
17
10
2020
pubmed:
18
10
2020
medline:
15
12
2020
Statut:
ppublish
Résumé
An asymptomatic carotid stenosis (CS) is defined as a stable atherosclerotic luminal narrowing in patients with no history of ipsilateral cerebral or ocular ischemic events in the past six months. The bifurcation of the common carotid artery makes this area vulnerable to atherosclerosis due to the features of haemodynamic flow. The exact prevalence of asymptomatic patients with CS remains unknown and opinions on the treatment of these patients are controversial. The authors aimed to review the evidence on the management of the asymptomatic CS and describe its clinical characteristics, diagnosis and treatment management. A comprehensive review of the literature was carried out to collate data from relevant studies concerning patients with extracranial moderate to severe asymptomatic carotid stenosis. The data used was identified by a search using PubMed and Google Scholar with the keywords / MESH terms "carotid stenosis", in combination with the term "asymptomatic". For this study, the authors focused on publications in the past two decades, using English publications. A few studies have addressed the prevalence, natural course and/or prognostic impact of asymptomatic CS in patients under medical treatment or undergoing vascular surgery procedures. The prevalence of asymptomatic CS ranged from 0.3% to 4.5% in women and 0.5% to 5.7% in men - The risk of stroke/TIA in these patients was reported between 2% to 5% annually with a downward trend across time to 0.5% with current best medical therapy. A great proportion of patients with asymptomatic CS should be submitted to conservative management with best medical therapy. However, selective surgical management should be considered if high risk features are present.
Sections du résumé
BACKGROUND
BACKGROUND
An asymptomatic carotid stenosis (CS) is defined as a stable atherosclerotic luminal narrowing in patients with no history of ipsilateral cerebral or ocular ischemic events in the past six months. The bifurcation of the common carotid artery makes this area vulnerable to atherosclerosis due to the features of haemodynamic flow. The exact prevalence of asymptomatic patients with CS remains unknown and opinions on the treatment of these patients are controversial.
OBJECTIVE
OBJECTIVE
The authors aimed to review the evidence on the management of the asymptomatic CS and describe its clinical characteristics, diagnosis and treatment management.
METHODS
METHODS
A comprehensive review of the literature was carried out to collate data from relevant studies concerning patients with extracranial moderate to severe asymptomatic carotid stenosis. The data used was identified by a search using PubMed and Google Scholar with the keywords / MESH terms "carotid stenosis", in combination with the term "asymptomatic". For this study, the authors focused on publications in the past two decades, using English publications.
RESULTS
RESULTS
A few studies have addressed the prevalence, natural course and/or prognostic impact of asymptomatic CS in patients under medical treatment or undergoing vascular surgery procedures. The prevalence of asymptomatic CS ranged from 0.3% to 4.5% in women and 0.5% to 5.7% in men - The risk of stroke/TIA in these patients was reported between 2% to 5% annually with a downward trend across time to 0.5% with current best medical therapy.
CONCLUSION
CONCLUSIONS
A great proportion of patients with asymptomatic CS should be submitted to conservative management with best medical therapy. However, selective surgical management should be considered if high risk features are present.
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM