Extracranial Cerebrovascular Disease
Key Points
Key Points
- Over the past two decades, the role and efficacy of carotid endarterectomy (CEA) and carotid artery stenting (CAS) have become established as alternatives to medical therapy for stroke prevention and treatment.
- Recent publications have clarified the management of extracranial carotid disease and prompted this update.
Guideline Recommendations
...ideline Recommendation...
...of Recommendations...
...tomatic carotid stenosis...
...1 For low surgical risk patients with...
2. Symptomatic carotid artery stenos...
...mend CEA over TF-CAS in low- and sta...
...Management of acute neurologic s...
...nts with recent stable stroke (modified Ra...
...patients undergoing revascularization within...
3.3 We recommend against revascular...
...creening...
...commend against the routine screening for...
....2 In selected asymptomatic patient...
...ptomatic patients who are undergoing screen...
...d carotid artery stenosis and coronary artery di...
...For patients with symptomatic carotid stenosis o...
....2. In patients with severe (70%-99%)...
...s requiring carotid intervention, staged or sy...
Best Practice Recommendations (Implementation Document)
...e Recommendations (Implementation Document)...
...maging Indications...
...plex ultrasound examination preferably performed i...
...Medical Therapy and Risk Factor Modifica...
...patients with arteriosclerotic arteria...
...Intervention Indications...
...For neurologically symptomatic p...
...e 1. Revascularization Techniques Wit...
...isk Surgical Risk for CEA Based on th...
...Technical Considera...
...ice of anesthesia local/regional vs g...
...on: eversion CEA versus traditional endarterect...
...here is Level 1 evidence to support a re...
Technical tips for high ca...
...Surgeons should anticipate the presence of d...
...age and hematoma after CEA...
...ecision for use of drainage post CEA should be lef...
Completion imag...
...insufficient evidence to recommend...
...ement of carotid coils an...
...al intervention for asymptomatic iso...
...ng of Carotid Intervention in...
...ement of acute neurologic syndro...
...s who present in less than 6 hours of on...
...rotid Artery Ste...
...cess...
...ing of the aortic arch and carotid bifurcation is...
...nical considerati...
...nsfemoral CAS should be performed wi...
...ost-PTA and Stent Selection...
...tection should be established before PTA during CA...
...CEA Indications and Techniques...
...In the appropriate clinical setting...
...ions of Carotid Interventi...
...ment of intraoperative or perioper...
If a patient awakens from CEA un...
Acute CAS complicatio...
...wing to MCA occlusion owing to embolizati...
...hemodynamic instability after CEA...
...Significant postoperative hypertension or hypot...
...l nerve injury (CNI) aft...
...rve injuries are best avoided by m...
...NI is diagnosed, expectant managem...
...ive MI risk after CEA...
...e MI after CEA is best avoided by appro...
...ound hematoma after CE...
...dance of wound hematoma is best accomplish...
...ne should be considered to reverse heparinization...
Prosthetic patch infection af...
...ts who have undergone CEA with prosthetic pat...
...nosis after CEA...
...use of patch angioplasty or eversion endarte...
...tenosis following...
...Most asymptomatic patients (>70% restenosis...
...ellaneous...
...us thrombolysis should be administered as first-l...
...roximal Vertebral Artery Dise...
...patients presenting with symptomatic ver...
...lic Disease and Proximal CCA Occlusive Di...
...ntions (open or endovascular) to treat...
...arotid Disease and Other Major Noncardiac...
...oncardiac surgery, preoperative carotid a...
Post Carotid Intervention Surveillance (CEA a...
...ter CEA or CAS, we recommend surve...