Asymptomatic Carotid Artery Stenosis: A Primer on Risk Stratification and Management

ISBN-13: 9781841846132 / Angielski / Twarda / 2007 / 244 str.

Issam D. Moussa; Tatjana Rundek; Jp Mohr

Opis

Of the approximately 700,000 new strokes per year occurring in the United States, 5% to 12% result from angiographically demonstrated carotid occlusive disease. Of these atheroembolic strokes, 75% to 80% occur without a warning stroke or transient cerebral ischemic symptoms. Therefore, asymptomatic carotid artery stenosis remains a significant cause of stroke morbidity and mortality. Management of these patients, however, is still one of the most controversial topics in the cerebrovascular disease literature. The Asymptomatic Carotid Atherosclerosis Study (ACAS) and the Asymptomatic Carotid Surgery Trial (ACST) showed a reduction of the risk of stroke in patients undergoing carotid endarterectomy (CEA) compared with those treated medically. However, due to the low risk of annual stroke in these patients and the surgical morbidity/mortality, the actual benefit of CEA, in terms of prevention of annual disabling stroke, may not justify its introduction into routine clinical practice in many clinicians'

Spis treści

1. Epidemiology and natural history of asymptomatic carotid artery stenosis  2. Pathobiology of the asymptomatic atherosclerotic carotid plaque  3. Cerebrovascular anatomy and physiology and mechanisms of first-ever ischemic stroke in patients with carotid artery stenosis  4. Who should be screened for asymptomatic carotid artery stenosis? 5. Diagnosis and clinical evaluation of patients with asymptomatic carotid artery stenosis 6. Medical treatment for patients with asymptomatic carotid artery stenosis 7. Risk stratification of patients with asymptomatic carotid artery stenosis: demographic and clinical considerations 8. Risk stratification of patients with asymptomatic carotid artery stenosis: evaluation of carotid stenosis severity, progression, and morphology by duplex ultrasound  9. Risk stratification of patients with asymptomatic carotid artery stenosis: transcranial Doppler-based evaluation of asymptomatic cerebral microemboli 10. Risk stratification of patients with asymptomatic carotid artery stenosis: evaluation of cerebrovascular reserve 11. Risk stratification of patients with asymptomatic carotid artery stenosis: role of inflammatory biomarkers for atherosclerosis 12. The role of carotid and cerebral angiography in the management of individuals with asymptomatic carotid artery stenosis 13. Carotid endarterectomy in patients with asymptomatic carotid artery stenosis 14. Carotid artery stenting in patients with asymptomatic carotid artery stenosis 15. Asymptomatic carotid atherosclerotic disease: guidelines and future directions

O autorze

Moussa, Issam D.; Rundek, Tatjana; Mohr, JP