Optimal Medical Treatment versus Carotid Endarterectomy: The Rationale and Design of the Aggressive Medical Treatment Evaluation for Asymptomatic Carotid Artery Stenosis (AMTEC) Study

2013 ◽  
Vol 10 (2) ◽  
pp. 269-274 ◽  
Author(s):  
Igor Kolos ◽  
Mikhail Loukianov ◽  
Nikolay Dupik ◽  
Sergey Boytsov ◽  
Alexandr Deev
Keyword(s):  
Carotid Artery ◽  
Medical Treatment ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Treatment Evaluation ◽  
Artery Stenosis ◽  
Asymptomatic Carotid ◽  
Asymptomatic Carotid Artery Stenosis

scholarly journals Asymptomatic carotid artery stenosis: time to rethink our therapeutic options?

2014 ◽  
Vol 36 (1) ◽  
pp. E2 ◽  
Author(s):  
Saul F. Morales-Valero ◽  
Giuseppe Lanzino
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Medical Therapy ◽  
Carotid Artery Stenosis ◽  
Large Scale ◽  
Artery Stenosis ◽  
Invasive Treatment ◽  
Asymptomatic Carotid ◽  
Potential Benefits ◽  
Asymptomatic Carotid Artery Stenosis

Asymptomatic carotid artery stenosis is a well-recognized risk factor for ischemic stroke, and its prevalence increases with age. In the late 1980s and in the 1990s, well-designed randomized trials established a definite advantage for carotid endarterectomy in reducing the risk of ipsilateral stroke when compared with medical therapy alone. However, medical treatment of cardiovascular disease has improved significantly over the past 2 decades, and this has, in turn, resulted in a decline of the stroke risk in patients with asymptomatic carotid artery stenosis treated medically. This improvement in medical therapy casts doubts on the effectiveness of large-scale invasive treatment in patients with asymptomatic carotid artery stenosis. Several studies have been conducted to identify possible subgroups of patients with asymptomatic stenosis who are at higher risk of stroke in order to maximize the potential benefits of invasive treatment. Ongoing large-scale trials comparing best current medical therapy to available invasive treatments, such as carotid endarterectomy and carotid artery stenting, are likely to shed some light on this debated topic in the near future. In this review, the authors summarize the current controversy surrounding the ideal management of asymptomatic carotid artery stenosis.

scholarly journals Carotid Endarterectomy (CEA) for Asymptomatic Carotid Artery Stenosis

2000 ◽  
Vol 28 (6) ◽  
pp. 448-453
Author(s):  
Chie YAMANAKA ◽  
Takeshi SHIMA ◽  
Masahiro NISHIDA ◽  
Kanji YAMANE ◽  
Takashi HATAYAMA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Asymptomatic Carotid ◽  
Asymptomatic Carotid Artery Stenosis

Strategies for asymptomatic carotid artery stenosis

2011 ◽  
Vol 31 (6) ◽  
pp. E9 ◽  
Author(s):  
Christopher Doe ◽  
Pinakin R. Jethwa ◽  
Chirag D. Gandhi ◽  
Charles J. Prestigiacomo
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Medical Management ◽  
Carotid Artery Stenosis ◽  
Treatment Options ◽  
Artery Stenosis ◽  
Carotid Angioplasty ◽  
Asymptomatic Carotid ◽  
The Past ◽  
Asymptomatic Carotid Artery Stenosis

The treatment of asymptomatic carotid artery stenosis (ACAS) has continued to evolve for the past 3 decades. With rapidly advancing technology, the results of old trials have become obsolete. While there has been little change in the efficacy of carotid endarterectomy, there have been vast improvements in both medical management and carotid angioplasty with stenting. Finding the best therapy for a given patient can therefore be difficult. In this article, the authors review the current literature regarding treatment options for ACAS and the methods available for stratifying patients who would benefit from surgical versus medical treatment.

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