[Advances in carotid endarterectomy--review]

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Context:

• Carotid artery stenosis is a significant risk factor for ischemic stroke, a leading cause of death and adult disability.
• The severity of carotid stenosis directly correlates with the increased risk of stroke.
• Accurate diagnosis of stenosis degree is crucial for timely intervention.

Purpose:

• To review the diagnostic methods for carotid artery stenosis.
• To highlight carotid endarterectomy as the primary surgical treatment for high-grade stenosis.
• To discuss the microsurgical technique and its advantages in arterial repair.

Summary:

• Diagnosis of carotid stenosis is achieved through duplex sonography, MR-angiography, CT-angiography, and conventional angiography.
• Carotid endarterectomy, established in 1953, remains the gold standard for treating high-grade carotid stenosis.
• Microsurgical techniques allow for precise endarterectomy and arterial repair, potentially avoiding the need for patch grafting.

Impact:

• Effective management of carotid stenosis reduces the incidence of ischemic stroke and associated mortality.
• Carotid endarterectomy improves patient outcomes by preventing debilitating neurological deficits.
• Ongoing evaluation of alternative treatments like angioplasty with stenting continues to refine stroke prevention strategies.