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Risk-Benefit Assessment of Carotid Revascularization
Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the mai...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cardiologia - SBC
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199518/ https://www.ncbi.nlm.nih.gov/pubmed/30365684 http://dx.doi.org/10.5935/abc.20180208 |
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author | de Oliveira, Pedro Piccaro Vieira, José Luiz da Costa Guimarães, Raphael Boesche Almeida, Eduardo Dytz Savaris, Simone Louise Portal, Vera Lucia |
author_facet | de Oliveira, Pedro Piccaro Vieira, José Luiz da Costa Guimarães, Raphael Boesche Almeida, Eduardo Dytz Savaris, Simone Louise Portal, Vera Lucia |
author_sort | de Oliveira, Pedro Piccaro |
collection | PubMed |
description | Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of a periprocedural risk of less than 6% in symptomatic patients. The medical therapy significantly reduced the revascularization net benefit ratio for stroke prevention in asymptomatic patients. Real life registries indicate that carotid stenting is associated with a greater periprocedural risk. The operator annual procedure volume and patient age has an important influence in the rate of stroke and death after carotid stenting. Symptomatic patients have a higher incidence of death and stroke after the procedure. Revascularization has the greatest benefit in the first weeks of the event. There is a discrepancy in the scientific literature about carotid revascularization and/or clinical treatment, both in primary and secondary prevention of patients with carotid artery injury. The identification of patients who will really benefit is a dynamic process subject to constant review. |
format | Online Article Text |
id | pubmed-6199518 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Sociedade Brasileira de Cardiologia - SBC |
record_format | MEDLINE/PubMed |
spelling | pubmed-61995182018-10-29 Risk-Benefit Assessment of Carotid Revascularization de Oliveira, Pedro Piccaro Vieira, José Luiz da Costa Guimarães, Raphael Boesche Almeida, Eduardo Dytz Savaris, Simone Louise Portal, Vera Lucia Arq Bras Cardiol Review Article Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of a periprocedural risk of less than 6% in symptomatic patients. The medical therapy significantly reduced the revascularization net benefit ratio for stroke prevention in asymptomatic patients. Real life registries indicate that carotid stenting is associated with a greater periprocedural risk. The operator annual procedure volume and patient age has an important influence in the rate of stroke and death after carotid stenting. Symptomatic patients have a higher incidence of death and stroke after the procedure. Revascularization has the greatest benefit in the first weeks of the event. There is a discrepancy in the scientific literature about carotid revascularization and/or clinical treatment, both in primary and secondary prevention of patients with carotid artery injury. The identification of patients who will really benefit is a dynamic process subject to constant review. Sociedade Brasileira de Cardiologia - SBC 2018-10 /pmc/articles/PMC6199518/ /pubmed/30365684 http://dx.doi.org/10.5935/abc.20180208 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article de Oliveira, Pedro Piccaro Vieira, José Luiz da Costa Guimarães, Raphael Boesche Almeida, Eduardo Dytz Savaris, Simone Louise Portal, Vera Lucia Risk-Benefit Assessment of Carotid Revascularization |
title | Risk-Benefit Assessment of Carotid Revascularization |
title_full | Risk-Benefit Assessment of Carotid Revascularization |
title_fullStr | Risk-Benefit Assessment of Carotid Revascularization |
title_full_unstemmed | Risk-Benefit Assessment of Carotid Revascularization |
title_short | Risk-Benefit Assessment of Carotid Revascularization |
title_sort | risk-benefit assessment of carotid revascularization |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199518/ https://www.ncbi.nlm.nih.gov/pubmed/30365684 http://dx.doi.org/10.5935/abc.20180208 |
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