26^th European Neurology Congress

Stroke is the third most common cause of death all over the world after ischemic heart disease and cancer. Approximately 30% of the patients die within the first year of having a stroke and another 50% are left disabled (1). Atherosclerotic disease at the carotid bifucation has been shown to be responsable for greater than 20% to 25% of all strokes (2). A clear separation

between symptomatic and asymptomatic carotid artery stenosis is critical. If the patient has transient or permanent focal neurologic symptoms related to the ipsilateral retina or the cerebral hemisphere, is considered to be symptomatic (3). Carotid endarterectomy should be strongly considered for symptomatic patients with 70% to 99% stenosis and should also be considered for symptomatic patients with 50% to 69% stenosis if no other etiologic basis for the ischemic symptoms can be found. Surgery should be recommended only in selected patients with asymptomatic carotid artery stenosis because of the marginal benefit from revascularization in this patient population (4). Prompt evaluation and triage of patients with symptomatic carotid artery stenosis are essential to minimize the risk of early recurrent cerebrovascular events (5). In conclusion, symptomatic carotid artrey syndromes need urgent carotid duplex, MRI or DSA evaluation to determine the need for urgent surgery. Those with

the greatest degree of stenosis derive the greatest benefit from timely carotid endarterectomy.

 

Recent Publications : 

1. Louridas G, Junaid A. Management of carotid artery stenosis. Can Fam Physician 2005; 10(7): 984-989

 

2. Mintz BL, Hobson RW. Diagnosis and treatment of carotid artrey stenosis. JAOA 2000; 100(11): 22-26

 

3. Lanzino G, Rabinstein AA, Brown RD. Treatment of carotid artrey stenosis: Medical therapy, surgery, or stenting? Mayo Clin Proc 2009; 84(4): 362-368

 

4. Hobson RW et al. Management of atherosclerotic carotid artery disease: Clinical practice guidelines of the Society for Vascular Surgery. Journal of vascular surgery 2008; 48(2): 480-486

 

5. Rothwell PM, Giles MF, Chandratheva A, et al. Early use of Existing Preventive Strategies for Stroke (EXPRESS) study Eff ect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): A prospective population-based sequential comparison. Lancet 2007; 370(9596):1432-1442.