Stroke in 2010: Clearing the air on clearing the carotid.

摘要

Carotid artery atherosclerosis is an important cause of stroke and accounts for approximately one in six strokes occurring annually.1 Surgical revascularization of severe carotid artery disease in patients with recent neurological symptoms is well established as clinically beneficial and cost-effective, but questions remain about various aspects of optimization of carotid artery atherosclerotic disease management.1 At the beginning of 2010, we had yet to establish whether the less invasive option of percutaneous stenting of the carotid artery is a safe and efficacious alternative to surgical revascularization in patients or subgroups of patients with symptomatic carotid artery disease. Also, data on the role of transcranial Doppler (TCD) ultrasound in predicting stroke risk in patients with asymptomatic carotid stenosis were conflicting. Finally, the long-term efficacy of prompt surgical revascularization in patients with severe carotid artery narrowing but no recent neurological symptoms was unknown