Perioperative Medical Management for Symptomatic Carotid Artery Interventions

AbstractPurpose of ReviewThe goal of this review is to provide the reader with an overview of symptomatic carotid stenosis and the approach to medical management of patients undergoing surgical intervention with both carotid endarterectomy (CEA) and carotid artery stenting (CAS).Recent FindingsCEA is recommended for patients with moderate to severe symptomatic carotid stenosis and transient ischemic attack (TIA) or non-disabling stroke. More recently CAS has also been shown to be a beneficial, less invasive option for patients with symptomatic carotid stenosis. All patients need urgent medical therapy to reduce the risk of stroke before, during, and after surgical intervention. These therapies have traditionally included single anti-platelet and/or anticoagulation therapy. More recent studies have demonstrated the benefit of dual antiplatelet therapy (DAPT) and lipid-lowering medications, specifically statins.SummaryPatients with symptomatic carotid stenosis who are undergoing CEA or CAS must also be placed on the appropriate medical therapy during this time. General guidelines exist regarding the approach to medical management; however, largely due to the lack of modern randomized clinical trials, the specific management approach likely varies between institutions.

Source: Current Treatment Options in Cardiovascular Medicine - October 1, 2022 Category: Cardiology Source Type: research