Update in Carotid Disease.

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Background:

• Carotid endarterectomy is a key procedure for preventing ischemic stroke.
• Ongoing debates exist regarding optimal surgical techniques and alternative treatments.
• Recent literature provides new insights into managing complex carotid artery disease.

Purpose of the Study:

• To synthesize recent evidence on carotid endarterectomy and related interventions.
• To compare surgical techniques, endovascular options, and post-stroke management.
• To evaluate safety, restenosis, and treatment of combined carotid and coronary artery disease.

Main Methods:

• Comprehensive literature review of publications from the past five years.
• Analysis of studies addressing surgical techniques (eversion vs. classical with patch).
• Comparison of carotid endarterectomy versus angioplasty with stenting.

Main Results:

• Evidence on the comparative effectiveness of eversion versus classical carotid endarterectomy is analyzed.
• The optimal approach between carotid endarterectomy and angioplasty with stenting is discussed.
• Strategies for brain revascularization post-stroke, shunt use, and intraoperative stroke prevention are reviewed.

Conclusions:

• The review highlights current best practices and areas of ongoing research in carotid artery disease management.
• It provides guidance on managing restenosis, combined lesions, and the safety of carotid endarterectomy in the elderly.
• Informed decision-making for patients with carotid artery disease is supported by synthesized evidence.