Antiplatelet therapy for carotid artery stenting

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Neurology

Background:

• Carotid artery stenting (CAS) offers a less invasive alternative to carotid endarterectomy, with fewer systemic complications like myocardial infarction.
• CAS procedures carry a significant risk of ischemic complications, primarily due to distal thromboembolism.
• Advancements in distal protection devices and methods aim to mitigate thromboembolic events during CAS.

Purpose of the Study:

• To review the role of perioperative antiplatelet therapy in preventing ischemic events associated with CAS.
• To highlight the established standard of dual antiplatelet therapy in the perioperative management of CAS.

Main Methods:

• Review of current literature and clinical practices regarding CAS.
• Analysis of the impact of antiplatelet therapies on preventing thromboembolism.
• Evaluation of the efficacy of dual antiplatelet therapy in perioperative CAS management.

Main Results:

• Dual antiplatelet therapy plays a crucial role in preventing perioperative ischemic events.
• The incidence of systemic complications is lower with CAS compared to carotid endarterectomy.
• Distal thromboembolism remains a key concern in CAS, necessitating protective strategies.

Conclusions:

• Dual antiplatelet therapy is the standard of care for perioperative management in carotid artery stenting.
• While CAS is less invasive, vigilance against distal thromboembolism is essential.
• Further research may explore optimized antiplatelet regimens for CAS patients.