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The fate of asymptomatic severe carotid stenosis in the era of best medical therapy.
- Source :
-
Brain Injury . 2017, Vol. 31 Issue 13/14, p1711-1717. 7p. - Publication Year :
- 2017
-
Abstract
- Background: Medical therapy for asymptomatic carotid artery stenosis (ACAS) may obviate the carotid revascularization, according to recent literature reports, but many studies also considered moderate carotid artery stenosis (50–69% NASCET). This study reviews the most recent series of ACAS focusing on ipsilateral transient ischemic attack (TIA) stroke and annual risk of stroke in patients with ACAS ≥70%, thereby also evaluating the adherence to best medical therapy (BMT).Methods: A systematic review consisting of all the series of patients with ACAS being treated medically was performed, which was published after 2005. The annual pooled risk of ipsilateral TIA-stroke and stroke in patients with ACAS ≥70% was calculated. A subgroup of studies with BMT defined as ≥90% of the patients in antiplatelet and statin therapy was performed.Results: Eleven studies, with the enrolling period from 1996 to 2009, were reviewed. Overall, 2185 patients were considered, with a follow-up from 2 to 13 years, for a total of 6834 patients/year. The pooled risk was 3.4%/year for ipsilateral TIA-stroke and 1.6%/year for stroke. Five studies, published from 2014, had BMT adherence, for a total of 1665 patients/year. The pooled risk was 3.5%/year for ipsilateral TIA-stroke and for stroke.Conclusion: The most recent series of ACAS ≥70% and BMT had an overall stroke rate which is relatively low; however, the risk of developing symptoms is still relevant (3.4%/year). [ABSTRACT FROM PUBLISHER]
Details
- Language :
- English
- ISSN :
- 02699052
- Volume :
- 31
- Issue :
- 13/14
- Database :
- Academic Search Index
- Journal :
- Brain Injury
- Publication Type :
- Academic Journal
- Accession number :
- 126349407
- Full Text :
- https://doi.org/10.1080/02699052.2017.1346285