Carotid endarterectomy for symptomatic carotid stenosis

An Update on Italian Stroke Organization Guidelines on Carotid Endarterectomy and Stenting

“…Where CEA was beneficial, some subgroups of patients were found to benefit more than others (5–7). In line with these findings, a previous systematic review of the Cochrane Collaboration demonstrated the benefit of CEA when narrowing was at least 50% (8). Moreover, a meta-analysis reported that surgery increased the risk of ipsilateral stroke at five-years if CS was <30%, did not produce significant effects if CS was 30–49%, was marginally beneficial if CS was 50–69%, and markedly beneficial for 70–99% CS in the absence of near occlusion (9).…”

An Update on Italian Stroke Organization Guidelines on Carotid Endarterectomy and Stenting

“…Where CEA was beneficial, some subgroups of patients were found to benefit more than others (5–7). In line with these findings, a previous systematic review of the Cochrane Collaboration demonstrated the benefit of CEA when narrowing was at least 50% (8). Moreover, a meta-analysis reported that surgery increased the risk of ipsilateral stroke at five-years if CS was <30%, did not produce significant effects if CS was 30–49%, was marginally beneficial if CS was 50–69%, and markedly beneficial for 70–99% CS in the absence of near occlusion (9).…”

Carotid sonography and transesophageal echocardiography in patients with ischemic stroke or transient ischemic attack in the territory of the carotid artery

“…2 According to Cochrane's review, surgery reduced the relative risk of disabling stroke or death in the NASCET and ECST trials by 48% in patients with a severe stenosis (>80% for ECST or 70% for NASCET), and by 27% in patients with a moderate stenosis (70-79% for ECST or 50-69% for NASCET), whereas surgery was detrimental to patients with lesser degrees of stenosis. 26 In our population, the prevalence of atherosclerotic carotid plaques was 81%. The symptomatic ICA stenosis was 50% or more in 35 patients (18%) and 70% or more in 24 patients (12%), of whom 17 (9%) were eligible for carotid endarterectomy; the other 7 patients had a total occlusion.…”

Case Scenarios to Assess Australian General Practitioners’ Understanding of Stroke Diagnosis, Management, and Prevention

“…22 After carotid ultrasound that demonstrated Ͻ60% stenosis, 43.2% of GPs stated that a symptomatic patient (case 1) should definitely not be considered for CEA, which is in accordance with the NHMRC stroke guidelines 3 but contrary to the Cochrane review for symptomatic patients. 11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”

“…11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”

An Update on Italian Stroke Organization Guidelines on Carotid Endarterectomy and Stenting

“…Where CEA was beneficial, some subgroups of patients were found to benefit more than others (5–7). In line with these findings, a previous systematic review of the Cochrane Collaboration demonstrated the benefit of CEA when narrowing was at least 50% (8). Moreover, a meta-analysis reported that surgery increased the risk of ipsilateral stroke at five-years if CS was <30%, did not produce significant effects if CS was 30–49%, was marginally beneficial if CS was 50–69%, and markedly beneficial for 70–99% CS in the absence of near occlusion (9).…”

Carotid sonography and transesophageal echocardiography in patients with ischemic stroke or transient ischemic attack in the territory of the carotid artery

“…2 According to Cochrane's review, surgery reduced the relative risk of disabling stroke or death in the NASCET and ECST trials by 48% in patients with a severe stenosis (>80% for ECST or 70% for NASCET), and by 27% in patients with a moderate stenosis (70-79% for ECST or 50-69% for NASCET), whereas surgery was detrimental to patients with lesser degrees of stenosis. 26 In our population, the prevalence of atherosclerotic carotid plaques was 81%. The symptomatic ICA stenosis was 50% or more in 35 patients (18%) and 70% or more in 24 patients (12%), of whom 17 (9%) were eligible for carotid endarterectomy; the other 7 patients had a total occlusion.…”

Case Scenarios to Assess Australian General Practitioners’ Understanding of Stroke Diagnosis, Management, and Prevention

“…22 After carotid ultrasound that demonstrated Ͻ60% stenosis, 43.2% of GPs stated that a symptomatic patient (case 1) should definitely not be considered for CEA, which is in accordance with the NHMRC stroke guidelines 3 but contrary to the Cochrane review for symptomatic patients. 11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”

“…11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”

An Update on Italian Stroke Organization Guidelines on Carotid Endarterectomy and Stenting

“…Where CEA was beneficial, some subgroups of patients were found to benefit more than others (5–7). In line with these findings, a previous systematic review of the Cochrane Collaboration demonstrated the benefit of CEA when narrowing was at least 50% (8). Moreover, a meta-analysis reported that surgery increased the risk of ipsilateral stroke at five-years if CS was <30%, did not produce significant effects if CS was 30–49%, was marginally beneficial if CS was 50–69%, and markedly beneficial for 70–99% CS in the absence of near occlusion (9).…”

Carotid sonography and transesophageal echocardiography in patients with ischemic stroke or transient ischemic attack in the territory of the carotid artery

“…2 According to Cochrane's review, surgery reduced the relative risk of disabling stroke or death in the NASCET and ECST trials by 48% in patients with a severe stenosis (>80% for ECST or 70% for NASCET), and by 27% in patients with a moderate stenosis (70-79% for ECST or 50-69% for NASCET), whereas surgery was detrimental to patients with lesser degrees of stenosis. 26 In our population, the prevalence of atherosclerotic carotid plaques was 81%. The symptomatic ICA stenosis was 50% or more in 35 patients (18%) and 70% or more in 24 patients (12%), of whom 17 (9%) were eligible for carotid endarterectomy; the other 7 patients had a total occlusion.…”

Case Scenarios to Assess Australian General Practitioners’ Understanding of Stroke Diagnosis, Management, and Prevention

“…22 After carotid ultrasound that demonstrated Ͻ60% stenosis, 43.2% of GPs stated that a symptomatic patient (case 1) should definitely not be considered for CEA, which is in accordance with the NHMRC stroke guidelines 3 but contrary to the Cochrane review for symptomatic patients. 11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”

“…11 However, a further 39.2% stated that perhaps this patient should be considered for CEA in accordance with NASCET results 10 and the Cochrane review. 11 To ensure that eligible patients benefit from surgery, GPs need to be better informed about the indications for CEA and refer patients appropriately.…”