A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis.
10.7461/jcen.2015.17.2.101
- Author:
E Wook JANG
1
;
Joonho CHUNG
;
Kwon Duk SEO
;
Sang Hyun SUH
;
Yong Bae KIM
;
Kyung Yul LEE
Author Information
1. Department of Neurosurgery, Cerebrovascular Center, Gangnam Severance Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Carotid artery stenosis;
Carotid artery stenting;
Carotid endarterectomy;
Protocol
- MeSH:
Carotid Arteries;
Carotid Stenosis*;
Constriction, Pathologic;
Endarterectomy, Carotid;
Humans;
Stents
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2015;17(2):101-107
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. MATERIALS AND METHODS: A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. RESULTS: CEA or CAS is indicated when the patient has a symptomatic stenosis > or = 50%, or when the patient has an asymptomatic stenosis > or = 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. CONCLUSION: We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.
