Management of extracranial carotid artery stenosis

Extracranial carotid artery stenosis

Abstract

Extracranial carotid artery stenosis is an important cause of ischemic stroke. It is the second leading cause of death in the world, accounting for 9.5 percent of all causes of death. It has a high mortality rate of 15 percent and leads to 15-20 percent of disability. The main factor is atherosclerosis-induced stenosis from the deposition of fibrofatty plaques in the artery walls. Distal embolization of atherosclerotic plaque to intracerebral arteries and low flow state due to proximal stenosis are main pathophysiology of ischemic stroke in patients with carotid artery stenosis. Diagnosis of such disease consists of non-invasive vascular lab to invasive test. Treatment of carotid artery included best medical treatment, revascularization by open surgery and endovascular intervention.

Currently, there are both randomized control trials and meta-analysis report on the diagnostic study, medical and operative treatment using new technology. The updated patient care guidelines on management during preoperative, perioperative and intraoperative period leading to better treatment results.

This article compiles and summarizes guidelines and research for physicians, surgeons and radiologist who are involved in the treatment of patients with carotid artery disease at different levels. Keeping up-to-date management of disease is very important for the treatment effect.