Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2009 April;50(2) > The Journal of Cardiovascular Surgery 2009 April;50(2):171-82



Publishing options
To subscribe
Submit an article
Recommend to your librarian





The Journal of Cardiovascular Surgery 2009 April;50(2):171-82


language: English

SPREAD Italian Guidelines for stroke. Indications for carotid endarterectomy and stenting*

Setacci C. 1, Lanza G. 2, Ricci S. 3, Cao P. G. 4, Castelli P. 5, Cremonesi A. 6, Inzitari D. 7, Novali C. 8, Pratesi C. 9, Speziale F. 10, Mangiafico S. 11, Zaninelli A. 12, Gensini G. F. 12

1 Department of Vascular Surgery University of Siena Siena Italy 2 Department of Vascular Surgery IRCCS MultiMedica Castellanza Varese Italy 3 Department of Neurology and Stroke Local Health Unit N. 2 Perugia Italy 4 Department of Vascular and Endovascular Surgery University of Perugia Perugia Italy 5 Department of Surgical Sciences University of Insubria, Varese, Italy 6 Department of Medical and Surgical Cardiology Cecilia Hospital Cotignola Ravenna Italy 7 Department of Neurology University of Florence Florence Italy 8 Department of Vascular Surgery Hospital of Cuneo Cuneo Italy 9 Department of Vascular Surgery University of Florence Florence Italy 10 Department of Vascular Surgery University of Rome Italy 11 Department of Neuroradiology University of Florence, Florence, Italy 12 University of Florence,School of Medicine Florence Italy


This multidisciplinary guideline provides an overview of the current evidence on the benefits obtained by endoarterectomy and stenting for the surgical treatment of patients with symptomatic and asymptomatic carotid stenosis. A hundred forty-six authors, 37 Italian scientific societies and two Italian patients’ associations participated in drafting the Stroke Prevention and Educational Awareness Diffusion (SPREAD) document, which has become the national guideline for the prevention and treatment of stroke in Italy. For the surgical therapy section of this document, the main trials on carotid endoarterectomy and stenting were critically reviewed following The Scottish Intercollegiate Guideline Network Oxford Centre for Evidence-Based Medicine methodology in order to formulate recommendations and syntheses for these procedures. The final document was peer reviewed and approved by all the participants. Recommendations and syntheses are presented for the referral of patients to either carotid endoarterectomy or stenting on the basis of whether carotid stenosis is symptomatic or asymptomatic, on the presence of various risk factors such as degree of arterial narrowing, and on concomitant pathology (cardiopathy and acute stroke).

top of page