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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Italian Journal of Vascular and Endovascular Surgery 2013 December;20(4):189-96

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

The management of the asymptomatic patient with carotid atherosclerosis

Thapar A. 1, Farooq A. 2, Munster A. 3, Onida S. 4, Shalhoub J. 3, Davies A. H. 5

1 Princess Alexandra Hospital, Harlow, Essex, UK; 2 Heatherwood and Wexham Park Hospitals NHS Trust Ascot, Berkshire, UK; 3 Department of Biomedical Science Imperial College London, London, UK; 4 Northwick Park Hospitals NHS Trust, London, UK; 5 Department of Vascular Surgery, Imperial College London, London, UK


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Both carotid revascularization and medical therapy have become safer since the first reported carotid endarterectomy in 1954, however the management of asymptomatic individuals with carotid atherosclerosis remains a source of trans-Atlantic debate. This review discusses whether clinicians should screen for the condition, the latest annual stroke rates on contemporary medical therapy, risk stratification applicable to clinical practice, results of recent randomized controlled trials of surgery versus stenting, cost-effectiveness of revascularization and finally on-going trials in this field.

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a.h.davies@imperial.ac.uk