Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis

Intervention versus Aggressive Medical Therapy for Cognition in Severe Asymptomatic Carotid Stenosis.

BACKGROUND AND PURPOSE Asymptomatic carotid stenosis of ≥70% increases the incidence of microembolism and/or chronic hypoperfusion, which may consequently impair neurocognition and brain connections. We sought controlled evidence for any cognitive benefit of aggressive medical therapy and combined carotid revascularization. MATERIALS AND METHODS Patients with asymptomatic, unilateral, ≧70% st...

Aggressive medical therapy alone is adequate in certain patients with severe symptomatic carotid stenosis.

Aggressive medical therapy alone is not adequate in certain patients with severe symptomatic carotid stenosis.

he results of the first European Carotid Surgery Trial (ECST) and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) led to guidelines recommending carotid endarterectomy (CEA) for patients matching the trial characteristics, which are still current today. Thus, if you observe the guidelines, this patient should be referred for CEA. However, analysis of the trial data suggests...

Carotid endarterectomy for asymptomatic carotid stenosis: asymptomatic carotid surgery trial.

Effective prevention is inarguably the best option for reducing the individual and societal burden of stroke. For each patient, clinicians balance the benefits of a given preventive therapy against its associated risks and costs. Where possible, these assessments should be based on the results of randomized clinical trials. Carotid endarterectomy (CEA), the most-commonly used surgical procedure...

Surgical or medical management for asymptomatic carotid stenosis.

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