Optimal management of asymptomatic carotid stenosis in 2021: the jury is still out. An international, multispecialty, expert review and position statement

• Tipo: Artigo em Revista Científica Internacional
• Data: 2022

Autores

Paraskevas, KI (Autor) Outra; Mikhailidis, DP (Autor) Outra; Antignani, PL (Autor) Outra; Baradaran, H (Autor) Outra; Bokkers, RPH (Autor) Outra; Cambria, RP (Autor) Outra; Dardik, A (Autor) Outra; Davies, AH (Autor) Outra; Eckstein, HH (Autor) Outra; Faggioli, G (Autor) Outra; Fernandes, JFE (Autor) Outra; Fraedrich, G (Autor) Outra; Geroulakos, G (Autor) Outra; Gloviczki, P (Autor) Outra; Golledge, J (Autor) Outra; Gupta, A (Autor) Outra; Jezovnik, MK (Autor) Outra; Kakkos, SK (Autor) Outra; Katsiki, N (Autor) Outra; Knoflach, M (Autor) Outra; Kooi, ME (Autor) Outra; Lanza, G (Autor) Outra; Liapis, CD (Autor) Outra; Loftus, IM (Autor) Outra; Mansilha A. (Autor) FMUP; Millon, A (Autor) Outra; Nicolaides, AN (Autor) Outra; Pini, R (Autor) Outra; Poredos, P (Autor) Outra; Ricco, JB (Autor) Outra; Riles, TS (Autor) Outra; Ringleb, PA (Autor) Outra; Rundek, T (Autor) Outra; Saba, L (Autor) Outra; Schlachetzki, F (Autor) Outra; Silvestrini, M (Autor) Outra; Spinelli, F (Autor) Outra; Stilo, F (Autor) Outra; Sultan, S (Autor) Outra; Suri, JS (Autor) Outra; Zeebregts, CJ (Autor) Outra; Chaturvedi, S (Autor) Outra

Revista

A Revista está pendente de validação pelos Serviços Administrativos.

Título: INTERNATIONAL ANGIOLOGY

Vol. 41

Páginas: 158-169

ISSN: 0392-9590

Editora: EDIZIONI MINERVA MEDICA

Indexação

ISI Web of Knowledge - 0 Citações

Scopus

Outras Informações

ID Authenticus: P-00W-BS7

DOI: 10.23736/s0392-9590.21.04825-2

Abstract (EN): The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement was to reconcile the conflicting views on the topic. A literature review was performed with a focus on data from recent studies. Several clinical and imaging high-risk features have been identified that are associated with an increased long-term ipsilateral ischemic stroke risk in patients with ACS. Such high-risk clinical/imaging features include intraplaque hemorrhage, impaired cerebrovascular reserve, carotid plaque echolucency/ulceration/ neovascularization, a lipid-rich necrotic core, a thin or ruptured fibrous cap, silent brain infarction, a contralateral transient ischemic attack/stroke episode, male patients <75 years and microembolic signals on transcranial Doppler. There is growing evidence that 80-99% ACS indicate a higher stroke risk than 50-79% stenoses. Although aggressive risk factor control and BMT should be implemented in all ACS patients, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention in high risk patients to prevent future cerebrovascular events. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of ACS patients. (Cite this article as: Paraskevas KI, Mikhailidis DP, Antignani PL, Baradaran H, Bokkers RP, Cambria RP, et al. Optimal management of asymptomatic carotid stenosis in 2021: the jury is still out. An international, multispecialty, expert review and position statement. Int Angiol 2022;41:158-69. DOI: 10.23736/S03929590.21.04825-2)

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 12