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Asymptomatic patients: severity of carotid artery stenosis, assessment of other medical conditions, life expectancy, and other individual factors; evaluation of the risks versus benefits; and patient preference are considered when determining whether surgical intervention should be performed.
Carotid endarterectomy is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (i.e., be symptomatic), or be found by a doctor in the absence of symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients.
Carotid artery stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky.
The most common of cerebrovascular conditions treated by vascular surgeons is carotid artery stenosis which is a narrowing of the carotid arteries and may be either clinically symptomatic or asymptomatic (silent). Carotid artery stenosis is caused by atherosclerosis whereby the buildup of atheromatous plaque inside the artery causes narrowing.
This ambitious multicenter trial is designed to address critical questions regarding the management of asymptomatic carotid artery disease. [24] CREST-2 is testing whether medical management alone or medical management combined with carotid stenting or surgery is the superior treatment strategy for preventing strokes in these patients.
Appropriate carotid endarterectomy: Showed in 2005 ([12]) that with intensive medical therapy most patients with asymptomatic carotid stenosis cannot benefit from endarterectomy or stenting, and that the very small proportion (10%) who may benefit can be identified by microembolus detection on transcranial Doppler.
Testing for coronary artery disease or carotid artery disease is of unclear benefit. [20] While PAD is a risk factor for abdominal aortic aneurysms (AAA), there is no data on screening individuals with asymptomatic PAD for abdominal aortic aneurysms. [20] For people with symptomatic PAD, screening by ultrasound for AAA is not unreasonable. [20]
The carotid arteries cover the majority of the cerebrum. The common carotid artery divides into the internal and the external carotid arteries. The internal carotid artery becomes the anterior cerebral artery and the middle central artery. The ACA transmits blood to the frontal parietal. From the basilar artery are two posterior cerebral arteries.