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[Management of carotid artery stenosis]

Francesco Puccinelli1, Marco Roffi2, Nicolas Murith3

  • 1Département de radiologie, CHUV, 1011 Lausanne.

Revue Medicale Suisse
|July 21, 2017
PubMed

Insights

Carotid artery atherosclerosis is a major stroke cause. Recanalization is effective for symptomatic stenosis, and selectively for asymptomatic cases, balancing risks and benefits of endovascular vs. surgical options.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Carotid artery atherosclerosis is a primary cause of stroke.
  • Carotid artery recanalization efficacy is established for symptomatic stenosis >70% and moderate for 50-69% stenosis.

Purpose of the Study:

  • To review the therapeutic strategies for carotid artery stenosis.
  • To compare endovascular (angioplasty with stent) and surgical (endarterectomy) options.

Main Methods:

  • Review of current therapeutic options for carotid artery stenosis.
  • Analysis of procedural risks and benefits for different patient groups.

Main Results:

  • Carotid artery recanalization is recommended for symptomatic stenosis >70% and selectively for asymptomatic stenosis (70-90%) with low procedural risk (<3%).
  • Endovascular treatment may have higher periprocedural stroke risk but lower rates of myocardial infarction and nerve palsy compared to surgery.

Conclusions:

  • Therapeutic decisions for carotid artery stenosis require a multidisciplinary approach.
  • Individualized treatment strategies should balance efficacy and procedural risks.

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