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A Journal on Vascular and Endovascular Surgery
LATEST INSIGHTS IN ENDOVASCULAR SURGERY
Italian Journal of Vascular and Endovascular Surgery 2013 June;20(2):49-60
Carotid revascularization – New insights and state of the debate
Zayed M. A., Zhou W.
Division of Vascular and Endovascular Surgery Department of Surgery, Stanford University Stanford, CA, USA
Carotid artery stenosis increases the risk of ischemic stroke. Accordingly, intensive investigation of methods used to diagnose, screen, treat, and monitor patients with carotid artery stenosis have led to advancements in the field. However, despite voluminous literature as well as significant strides in the management of patients with carotid artery stenosis, some ambiguities remain. In fact, recent major society guidelines have provided inconsistent, and sometimes conflicting, recommendations regarding specific topics on the management of carotid artery stenosis. Here we review five such topics that have recently been contested in the literature: 1) screening for carotid artery stenosis; 2) management of asymptomatic carotid artery stenosis; 3) role of CAS in management of symptomatic carotid artery stenosis; 4) timing of carotid revascularization in symptomatic patients; and 5) concurrent carotid and coronary artery revascularization.