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Practice Current: How do you manage patients with a "hot carotid"?
Neurology. Clinical Practice
|December 28, 2018
Summary
Managing acutely symptomatic carotid stenosis ("hot carotid") requires careful anti-thrombotic treatment decisions while awaiting revascularization. Expert opinions and survey data address uncertainties in treating these high-stroke-risk patients.
Area of Science:
- Neurology
- Vascular Surgery
- Cardiology
Background:
- Acutely symptomatic carotid stenosis, or "hot carotid," presents a significant risk of recurrent stroke.
- Optimal acute management, especially anti-thrombotic therapy, remains uncertain for patients awaiting carotid revascularization (CEA/CAS).
- Presence of intraluminal thrombi further complicates treatment decisions.
Purpose of the Study:
- To gather global expert opinions on managing "hot carotid" patients awaiting CEA/CAS.
- To focus on appropriate anti-thrombotic treatment strategies in this high-risk group.
- To compare expert consensus with readership survey results on "hot carotid" management.
Main Methods:
- Solicited expert opinions worldwide regarding "hot carotid" patient management.
- Conducted an online survey of readership on anti-thrombotic treatment for "hot carotid" patients.
- Focused on decision-making processes for patients awaiting carotid endarterectomy (CEA) or angioplasty/stenting (CAS).
Main Results:
- Presents a synthesis of expert recommendations for anti-thrombotic therapy in "hot carotid" patients.
- Details the findings from an online survey reflecting broader clinical practice and opinions.
- Highlights areas of consensus and divergence in managing acute carotid stenosis.
Conclusions:
- Addresses critical uncertainties in the acute management of "hot carotid" patients.
- Provides guidance on anti-thrombotic strategies pending revascularization.
- Emphasizes the need for further research due to limited high-quality data.