Carotid stenosis – diagnosis and treatment

Česká verzia

Authors: Tomáš Novotný; Robert Staffa
Authors place of work: Centrum cévních onemocnění II. chirurgické kliniky LF MU a FN u sv. Anny Brno, přednosta prof. MUDr. Robert Staffa, Ph. D.
Published in the journal: Vnitř Lék 2015; 61(12): 1049-1066
Category: Reviews

Summary

Diagnosis and treatment of carotid stenosis is under incessant development. Especially in last years, we have noticed significant changes in opinions based on the results of meta-analyses of old evidence and the new evidence as well. Important factor involved is the fast development of new endovascular therapies. In reaction to these changes, several medical societies published their guidelines for the management of carotid stenosis. Even though, all of them are based practically on the same published medical evidence, they are not always similar in recommendations. The aim of our work was to summarize actual recommendations regarding management of carotid stenosis. The management of asymptomatic and symptomatic patients is being discussed separately where appropriate because these two groups of patients are very different. The recommendations for selection of type of intervention between carotid endarterectomy and carotid stenting were covered in detail as well.

Key words:
carotid endarterectomy – carotid stenosis – carotid stenting – guidelines

Zdroje

1. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med 1991; 325(7): 445–453.

2. European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 1998; 351(9113): 1379–1387.

3. Mayberg MR, Wilson SE, Yatsu F et al. Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis. Veterans Affairs Cooperative Studies Program 309 Trialist Group. JAMA 1991; 266(23): 3289–3294.

4. Brott TG, Halperin JL, Abbara S et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Circulation 2011; 124(4): 489–532.

5. Ricotta JJ, Aburahma A, Ascher E et al. Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease. J Vasc Surg 2011; 54(3): e1-e31. Dostupné z DOI: http://dx.doi.org/10.1016/j.jvs.2011.07.031.

6. European Stroke Organisation. Tendera M, Aboyans V, Bartelink ML et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 2011; 32(22): 2851–2906.

7. Liapis CD, Bell PR, Mikhailidis D et al. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur J Vasc Endovasc Surg 2009; 37(4 Suppl):S1-S19.

8. Carotid Stenting Guidelines Committee: an Inter-collegiate Committee of the RACP (ANZAN, CSANZ), RACS (ANZSVS) and RANZCR. Guidelines for patient selection and performance of carotid artery stenting. Intern Med J 2011; 41(4): 344–347.

9. Neequaye SK, Halliday AW. Carotid artery stenting: the 2011 NICE guidelines. Heart 2012; 98(4): 274–275.

10. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45(7): 2160–2236. Erratum in Correction. [Stroke. 2015]

11. Stone NJ, Robinson JG, Lichtenstein AH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129(25 Suppl 2): S1-S45. Erratum in Circulation. 2014; 129(25 Suppl 2): S46-S48.

12. Jauch EC, Saver JL, Adams HP Jr et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44(3): 870–947.

13. Zhu CZ, Norris JW. Role of carotid stenosis in ischemic stroke. Stroke 1990; 21(8): 1131–1134.

14. Marsico F, Giugliano G, Ruggiero D et al. Prevalence and severity of asymptomatic coronary and carotid artery disease in patients with abdominal aortic aneurysm. Angiology 2015; 66(4): 360–364.

15. Axelrod DA, Diwan A, Stanley JC et al. Cost of routine screening for carotid and lower extremity occlusive disease in patients with abdominal aortic aneurysms. J Vasc Surg 2002; 35(4): 754–758.

16. Vranes M, Davidovic L, Vasic D et al. Coexistence of internal carotid artery stenosis in patients with abdominal aortic aneurysm. Korean Circ J 2013; 43(8): 550–556.

17. Wang Y, Wang Y, Zhao X et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013; 369(1): 11–19.

18. Kennedy J, Hill MD, Ryckborst KJ et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol 2007; 6(11): 961–969.

19. Stone DH, Goodney PP, Schanzer A et al. Clopidogrel is not associated with major bleeding complications during peripheral arterial surgery. J Vasc Surg 2011; 54(3): 779–784.

20. Batchelder A, Hunter J, Cairns V et al. Dual Antiplatelet Therapy Prior to Expedited Carotid Surgery Reduces Recurrent Events Prior to Surgery without Significantly Increasing Peri-operative Bleeding Complications. Eur J Vasc Endovasc Surg 2015; 54(3):779–784. Dostupné z DOI: http://dx.doi.org/10.1016/j.ejvs.2015.07.019.

21. Rothwell PM, Eliasziw M, Gutnikov SA et al. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 2004; 363(9413): 915–924.

22. Mantese VA, Timaran CH, Chiu D et al. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease. Stroke 2010; 41: (10 Suppl): S31-S34.

23. ACST-2 Collaborative Group. Halliday A, Bulbulia R, Gray W et al. Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2). Eur J Vasc Endovasc Surg 2013; 46(5): 510–518.

24. Eslami MH, McPhee JT, Simons JP et al. National trends in utilization and postprocedure outcomes for carotid artery revascularization 2005 to 2007. J Vasc Surg 2011; 53(2): 307–315.

25. Rockman CB, Maldonado TS, Jacobowitz GR et al. Early carotid endarterectomy in symptomatic patients is associated with poorer perioperative outcomes. J Vasc Surg 2006; 44(3): 480–487.

26. Fairhead JF, Mehta Z, Rothwell PM. Population-based study of delays in carotid imaging and surgery and the risk of recurrent stroke. Neurology 2005; 65(3): 371–375.

27. Dellagrammaticas D, Lewis S, Colam B et al. Carotid endarterectomy in the UK: acceptable risks but unacceptable delays. Clin Med 2007; 7(6): 589–592.

28. Gladstone DJ, Oh J, Fang J et al. Urgency of carotid endarterectomy for secondary stroke prevention: results from the Registry of the Canadian Stroke Network. Stroke 2009; 40(8): 2776–2782.

29. Coull AJ, Lovett JK, Rothwell PM et al. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ 2004; 328(7435): 326.

30. Naylor AR, Gaines PA, Rothwell PM. Who benefits most from intervention for asymptomatic carotid stenosis: patients or professionals? Eur J Vasc Endovasc Surg 2009; 37(6): 625–632.