Assessing Carotid Revascularization

Carotid Revascularization: Carotid Endarterectomy

Carotid endarterectomy (CEA) is a procedure that has reliably decreased the risk of cerebrovascular events and death in patients with severe carotid stenosis. In this chapter, important concepts in the preoperative assessment of patients undergoing CEA will be reviewed. An overview of the clinical trials highlighting current indications will be provided, followed by a discussion of the surgical...

[Internal carotid artery revascularization].

Carotid endarterectomy remains the standard revascularization technique for the prevention of ischemic stroke resulting from severe carotid stenosis. Surgery is highly beneficial in patients with a symptomatic stenosis of 70% or greater that is not a total or near-total occlusion. The benefit becomes more diluted in patients with a symptomatic 50-69% stenosis, and surgery has no effect, or even...

Measuring Carotid Revascularization Quality.

Because US health care pivots from volume-based to valuebased strategies, there is growing emphasis on optimizing quality, safety, and appropriate utilization. Accordingly, to improve, we must be able to measure our performance. In this issue of Circulation: Cardiovascular Interventions, Kuehnl et al provide a timely publication, from the German national database, that informs our quest for the...

Carotid revascularization: risks and benefits

Despite a decline during the recent decades in stroke-related death, the incidence of stroke has remained unchanged or slightly increased, and extracranial carotid artery stenosis is implicated in 20%-30% of all strokes. Medical therapy and risk factor modification are first-line therapies for all patients with carotid occlusive disease. Evidence for the treatment of patients with symptomatic c...

Carotid Artery Revascularization: What's the Best Strategy?