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Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis

BACKGROUND: As per the current recommendations, carotid interventional procedures (carotid endarterectomy/carotid artery stenting) are considered superior to medical management in reducing the stroke recurrence in patients with symptomatic extracranial internal carotid artery (ICA) stenosis. OBJECTI...

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Autores principales: Deepa Rani, BV, Gampa, Sandeep, Sirineni, Deepika, Harshavardhana, K. R., Krishna, Satya Rama, Kaul, Subhash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137635/
https://www.ncbi.nlm.nih.gov/pubmed/30258258
http://dx.doi.org/10.4103/aian.AIAN_124_18
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author Deepa Rani, BV
Gampa, Sandeep
Sirineni, Deepika
Harshavardhana, K. R.
Krishna, Satya Rama
Kaul, Subhash
author_facet Deepa Rani, BV
Gampa, Sandeep
Sirineni, Deepika
Harshavardhana, K. R.
Krishna, Satya Rama
Kaul, Subhash
author_sort Deepa Rani, BV
collection PubMed
description BACKGROUND: As per the current recommendations, carotid interventional procedures (carotid endarterectomy/carotid artery stenting) are considered superior to medical management in reducing the stroke recurrence in patients with symptomatic extracranial internal carotid artery (ICA) stenosis. OBJECTIVE: The objective of this study is to compare the best medical management with carotid interventional procedures in the prevention of stroke recurrence in the patients with symptomatic extracranial ICA stenosis. MATERIALS AND METHODS: This was a parallel, prospective, two-arm, open-label, observational study. Participants were selected consecutively and prospectively among patients from Outpatient and Inpatient Departments of Neurology at Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India. The study period was from January 2012 to December 2017. RESULTS: Of 150 patients with symptomatic extracranial ICA stenosis of ≥50%, 100 preferred best medical management (m = 75, f = 25) and 50 (m = 37, f = 13) opted for carotid intervention. The mean age of the patient cohort was 59.8 ± 12.7. Follow-up was done at regular intervals from 3 months to 1 year. In the medical group, the recurrence occurred in 10 patients; 4 (40%) within 6 months, 5 (50%) within 6–12 months, and 1 (10%) after 1 year. In the intervention group, the recurrence occurred in 6 patients; 5 (83%) within the first 6 months and 1 (17%) within 6–12 months. CONCLUSIONS: Overall, there was no statistically significant difference in the rate of recurrence between the best medical management and the carotid interventional procedures.
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spelling pubmed-61376352018-09-26 Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis Deepa Rani, BV Gampa, Sandeep Sirineni, Deepika Harshavardhana, K. R. Krishna, Satya Rama Kaul, Subhash Ann Indian Acad Neurol Original Article BACKGROUND: As per the current recommendations, carotid interventional procedures (carotid endarterectomy/carotid artery stenting) are considered superior to medical management in reducing the stroke recurrence in patients with symptomatic extracranial internal carotid artery (ICA) stenosis. OBJECTIVE: The objective of this study is to compare the best medical management with carotid interventional procedures in the prevention of stroke recurrence in the patients with symptomatic extracranial ICA stenosis. MATERIALS AND METHODS: This was a parallel, prospective, two-arm, open-label, observational study. Participants were selected consecutively and prospectively among patients from Outpatient and Inpatient Departments of Neurology at Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India. The study period was from January 2012 to December 2017. RESULTS: Of 150 patients with symptomatic extracranial ICA stenosis of ≥50%, 100 preferred best medical management (m = 75, f = 25) and 50 (m = 37, f = 13) opted for carotid intervention. The mean age of the patient cohort was 59.8 ± 12.7. Follow-up was done at regular intervals from 3 months to 1 year. In the medical group, the recurrence occurred in 10 patients; 4 (40%) within 6 months, 5 (50%) within 6–12 months, and 1 (10%) after 1 year. In the intervention group, the recurrence occurred in 6 patients; 5 (83%) within the first 6 months and 1 (17%) within 6–12 months. CONCLUSIONS: Overall, there was no statistically significant difference in the rate of recurrence between the best medical management and the carotid interventional procedures. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6137635/ /pubmed/30258258 http://dx.doi.org/10.4103/aian.AIAN_124_18 Text en Copyright: © 2018 Annals of Indian Academy of Neurology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Deepa Rani, BV
Gampa, Sandeep
Sirineni, Deepika
Harshavardhana, K. R.
Krishna, Satya Rama
Kaul, Subhash
Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title_full Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title_fullStr Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title_full_unstemmed Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title_short Comparison of Best Medical Management with Carotid Intervention Procedures in the Prevention of Stroke Recurrence in Patients with Symptomatic Internal Carotid Artery Stenosis
title_sort comparison of best medical management with carotid intervention procedures in the prevention of stroke recurrence in patients with symptomatic internal carotid artery stenosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137635/
https://www.ncbi.nlm.nih.gov/pubmed/30258258
http://dx.doi.org/10.4103/aian.AIAN_124_18
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