The current strategic management of asymptomatic carotid stenosis
Keywords:
Asymptomatic carotid stenosis, Carotid endarterectomy, Carotid stent, Unstable plaque, High risks plaqueAbstract
Asymptomatic carotid stenosis has been enormously debated, especially in the aspect of ischemic neurological prevention. The better efficacy of antiplatelets and lipid lowering agents may be enough for prevention of stroke. Patient with high risk plaque have the greater risk of stroke than usual. The characters of high risk plaque such as rapidly progressive stenosis, larger plaque area, large lipid core, thin fibrous cap and the evidence of distal embolization should be elucidated in all patient with carotid stenosis
Carotid endarterectomy (CEA) or carotid stenting (CAS) are currently suitable treatment in asymptomatic carotid stenosis of >60-70%. Although, the CEA had the lower risk of perioperative complications, but the higher risk of postoperative myocardial infarction. Therefore, the CAS may be alternative treatment especially in the patient who had high risk of perioperative complication from CEA.
Despite of the many issues concerned for strategic planning of stroke prevention. Comprehensive discussion between physician and patient are also the crucial complementary strategy for stroke prevention therapy.
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
