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Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy
Patients with carotid artery stenosis (CAS) are commonly defined as asymptomatic or symptomatic according with their neurological conditions, however, emerging evidences suggest stratifying patients according also with the presence of cerebral ischemic lesions (CIL). In asymptomatic patients, the pr...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607094/ https://www.ncbi.nlm.nih.gov/pubmed/33178796 http://dx.doi.org/10.21037/atm-20-1098 |
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author | Pini, Rodolfo Vacirca, Andrea Palermo, Sergio Gallitto, Enrico Mascoli, Chiara Gargiulo, Mauro Faggioli, Gianluca |
author_facet | Pini, Rodolfo Vacirca, Andrea Palermo, Sergio Gallitto, Enrico Mascoli, Chiara Gargiulo, Mauro Faggioli, Gianluca |
author_sort | Pini, Rodolfo |
collection | PubMed |
description | Patients with carotid artery stenosis (CAS) are commonly defined as asymptomatic or symptomatic according with their neurological conditions, however, emerging evidences suggest stratifying patients according also with the presence of cerebral ischemic lesions (CIL). In asymptomatic patients, the presence of CIL increases the risk of future neurologic event from 1% to 4% per year, leading to a stronger indication to carotid revascularization. In symptomatic patients, the presence of CIL does not seem to influence the outcome of the carotid revascularization if the volume of the lesion is small (<4,000 mm(3)); the benefit of the revascularization is also more significant if performed within 2 weeks from the index event. However, high volume (>4,000 mm(3)) CIL are associated in some experiences with a higher risk of carotid revascularization suggesting to delay the carotid revascularization for at least 4 weeks. As a matter of fact, the evaluation of CIL dimensions and characteristics in patients with CAS gives to the physician involved in the treatment a valuable adjunctive tool in the choice of the ideal treatment. |
format | Online Article Text |
id | pubmed-7607094 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-76070942020-11-10 Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy Pini, Rodolfo Vacirca, Andrea Palermo, Sergio Gallitto, Enrico Mascoli, Chiara Gargiulo, Mauro Faggioli, Gianluca Ann Transl Med Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I Patients with carotid artery stenosis (CAS) are commonly defined as asymptomatic or symptomatic according with their neurological conditions, however, emerging evidences suggest stratifying patients according also with the presence of cerebral ischemic lesions (CIL). In asymptomatic patients, the presence of CIL increases the risk of future neurologic event from 1% to 4% per year, leading to a stronger indication to carotid revascularization. In symptomatic patients, the presence of CIL does not seem to influence the outcome of the carotid revascularization if the volume of the lesion is small (<4,000 mm(3)); the benefit of the revascularization is also more significant if performed within 2 weeks from the index event. However, high volume (>4,000 mm(3)) CIL are associated in some experiences with a higher risk of carotid revascularization suggesting to delay the carotid revascularization for at least 4 weeks. As a matter of fact, the evaluation of CIL dimensions and characteristics in patients with CAS gives to the physician involved in the treatment a valuable adjunctive tool in the choice of the ideal treatment. AME Publishing Company 2020-10 /pmc/articles/PMC7607094/ /pubmed/33178796 http://dx.doi.org/10.21037/atm-20-1098 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I Pini, Rodolfo Vacirca, Andrea Palermo, Sergio Gallitto, Enrico Mascoli, Chiara Gargiulo, Mauro Faggioli, Gianluca Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title | Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title_full | Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title_fullStr | Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title_full_unstemmed | Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title_short | Impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
title_sort | impact of cerebral ischemic lesions on the outcome of carotid endarterectomy |
topic | Review Article on Carotid Artery Stenosis and Stroke: Prevention and Treatment Part I |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607094/ https://www.ncbi.nlm.nih.gov/pubmed/33178796 http://dx.doi.org/10.21037/atm-20-1098 |
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