The optimal management of patients with asymptomatic carotid stenosis (AsxCS) is the subject of extensive debate.
The recommendations of international guidelines for the management of AsxCS often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with carotid endarterectomy (CEA)/carotid artery stenting (CAS) plus BMT. Although aggressive risk factor control and BMT should be implemented in all patients with AsxCS, several high-risk features that may increase the risk of a future cerebrovascular event are now documented. Consequently, some guidelines recommend a prophylactic carotid intervention (CEA/CAS) in high-risk patients to prevent future cerebrovascular events.
Besides these clinical/imaging characteristics, there are additional individual, ethnic/racial or social factors that should probably be evaluated in the decision process regarding the optimal management of these patients, such as individual patient needs/patient choice, patient compliance with best medical treatment, patient sex, culture, race/ethnicity, age and comorbidities, as well as improvements in imaging/operative techniques and outcomes.
The present interactive talk will discuss the indications in the treatment of patients with AsxCS. Until the results of the much-anticipated randomized controlled trials emerge, the jury is still out regarding the optimal management of AsxCS patients.
Il seminario si terrà in Sala Conferenze PRABB.
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