Medical Management of Asymptomatic Carotid Artery Stenosis

Aaron W Aday; Joshua A Beckman

doi:10.1016/j.pcad.2017.05.008

Medical Management of Asymptomatic Carotid Artery Stenosis

Prog Cardiovasc Dis. 2017 May-Jun;59(6):585-590. doi: 10.1016/j.pcad.2017.05.008. Epub 2017 May 21.

Authors

Aaron W Aday¹, Joshua A Beckman²

Affiliations

¹ Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
² Cardiovascular Division, Vanderbilt University Medical Center, Nashville, TN. Electronic address: Joshua.a.beckman@vanderbilt.edu.

PMID: 28539213
DOI: 10.1016/j.pcad.2017.05.008

Abstract

Carotid artery atherosclerosis is a major risk factor for both stroke and cardiovascular disease. Appropriate management of asymptomatic patients with carotid artery stenosis (CAS) remains unclear. Although several randomized clinical trials support revascularization in asymptomatic patients with severe CAS to reduce stroke risk, the participants in these trials did not receive optimal medical therapy (OMT) by today's standards. For many individuals, medical therapy may provide excellent risk reduction without the periprocedural risk of endarterectomy or stenting. In this review, we discuss the risk factors for CAS and stroke and examine the data for each component of OMT in these patients.

Keywords: Atherosclerosis; Carotid artery stenosis; Hypertension; Statin; Stroke.

Publication types

Review

MeSH terms

Asymptomatic Diseases
Cardiovascular Agents / therapeutic use*
Carotid Stenosis / complications
Carotid Stenosis / diagnosis
Carotid Stenosis / therapy*
Humans
Risk Assessment
Risk Factors
Risk Reduction Behavior*
Stroke / etiology
Stroke / prevention & control*
Treatment Outcome

Substances

Cardiovascular Agents