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Review
Update in the treatment of extracranial atherosclerotic disease for stroke prevention
  1. Zhu Zhu1,2,
  2. Wengui Yu1
  1. 1 Department of Neurology, University of California Irvine, Irvine, California, USA
  2. 2 Department of Neurology, Huashan Hospital Fudan University, Shanghai, China
  1. Correspondence to Dr Wengui Yu, Department of Neurology, University of California, Manchester, CA 9286, USA; wyu{at}uci.edu

Abstract

Stroke is a leading cause of adult mortality and disability worldwide. Extracranial atherosclerotic disease (ECAD), primarily, carotid artery stenosis, accounts for approximately 18%–25% of ischaemic stroke. Recent advances in neuroimaging, medical therapy and interventional management have led to A significant reduction of stroke from carotid artery stenosis. The current treatment of ECAD includes optimal medical therapy, carotid endarterectomy (CEA) and carotid artery stenting (CAS). The selection of treatments depends on symptomatic status, severity of stenosis, individual factors, efficacy and risk of complications. The aim of this paper is to review current evidence and guidelines on the management of carotid artery stenosis, including the comparison of medical and interventional therapy (CAS and CEA), as well as future directions.

  • atherosclerosis
  • intervention
  • stroke
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/svn-2019-000261

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    Footnotes

    • Contributors ZZ: wrote the first draft of the manuscript. WY: supervised, critically reviewed and edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.