High stroke rate in patients with medically managed asymptomatic carotid stenosis at an academic center in the Southeastern United States

Since the publication of randomized clinical trials defining the benefit of carotid endarterectomy (CEA) for asymptomatic carotid stenosis, medical management of carotid stenosis has changed significantly. With antiplatelet agents and statins, some question whether these trials are still relevant, suggesting that asymptomatic patients with>70% internal carotid artery (ICA) stenosis may do better with medial management alone, lessening the need for CEA and carotid stenting. The Vascular Quality Initiative (VQI) registry has shown that there are wide practice variations regarding the degree of stenosis that prompts surgical intervention, but there are few reports of outcomes in patients who do not undergo intervention.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: General Review Source Type: research