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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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  CAROTID ARTERY STENTING UPDATE


The Journal of Cardiovascular Surgery 2011 December;52(6):803-19

lingua: Inglese

Medical treatment in carotid artery intervention

Kolkert J. L. 1, Meerwaldt R. 1, Lefrandt J. D. 2, Geelkerken R. H. 1, Zeebregts C. J. 3

1 Department of Surgery, Medisch Spectrum Twente Enschede, The Netherlands;
2 Division of Vascular Medicine, Department of Internal Medicine, Groningen Medical Center, University of Groningen, Groningen, The Netherlands;
3 Division of Vascular Surgery, Department of Surgery, Groningen Medical Center, University of Groningen, Groningen, The Netherlands


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Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

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czeebregts@hotmail.com