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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...

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Autores principales: Pini, Rodolfo, Vacirca, Andrea, Palermo, Sergio, Gallitto, Enrico, Mascoli, Chiara, Gargiulo, Mauro, Faggioli, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
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.
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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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