Commentary on 'Carotid artery disease: selecting the appropriate asymptomatic patient for intervention'.

摘要

Intervention in patients with asymptomatic carotid artery disease has been debated back and forth by neurologists, vascular surgeons, neurosurgeons, and interventionalists for the past 20 years.In their article, Drs Rockman and Riles reiterate the numerous prospective randomized trials that have unequivocally demonstrated the benefit and durability of endarter-ectomy in the treatment of symptomatic and asymptomatic extracranial carotid artery atherosclerosis. These studies help clinicians present logical plans to those patients who present with asymptomatic hemodynamically significant bifurcation disease. The goal of this operation is solely to prevent stroke and preserve neurologic function. The most important caveat derived from ACAS and NASCET was a benchmark to give patients realistic outcomes in order for us to offer patients a reasonable, safe, and durable plan that protects them from stroke, be it medical, surgical, or endovascular.