Medicina Fluminensis, Vol. 49 No. 1, 2013.
Review article
Clinical presentation, diagnostics and guidelines in treatment of patients with carotid artery stenosis
Ines Strenja-Linić
; Zavod za cerebrovaskularne i ekspanzivne bolesti, Klinika za neurologiju, KBC Rijeka, Rijeka
Miljenko Kovačević
; Zavod za torakovaskularnu kirurgiju, Klinika za kirurgiju, KBC Rijeka, Rijeka
Slavica Kovačić
; Zavod za radiologiju, KBC Rijeka, Rijeka
Tea Čaljkušić-Mance
; Klinika za oftalmologiju, KBC Rijeka, Rijeka
Ivo Miljanović
; KBC Rijeka, Rijeka
Damir Hasandić
; Županijski zavod za hitnu medicinu PGŽ-a, Rijeka
Aron Grubešić
; Županijski zavod za hitnu medicinu PGŽ-a, Rijeka
Abstract
Cerebrovascular diseases are a significant public health issue in the world as well as
in our own country and represent one of the leading causes of death. Early screening in carotid
stenosis patients, CEA (carotid endthrombarterectomy) and CAS (carotid artery stenting)
endovascular treatment as well as modification of cardiovascular risk factors is of paramount
importance in primary and secondary prevention of stroke. Color Doppler ultrasound procedures
play a key role in cerebrovascular disease diagnostics and enable an objective real time
approximation of cerebral haemodynamics. In order to maximalize success, surgical procedures
must be performed immediately following a TIA (Transitory ischemic attack). Summated
analysis of randomized control studies lean towards a maximum success of CEA following no
more than 2 weeks after a mild stroke or TIA. Endovascular should be complementary to surgical
treatment and all decisions on the course of the treatment should be delivered by a
team of neurologists, vascular surgeons and an intervention neuroradiologist. Medicamentous
treatment of carotid stenosis includes antiagreggational therapy, treatment of risk factors,
change of life habits as well as dietary measures. Today, there are several controversies
when considering treatment of carotid stenosis, many of which are still underway.
Keywords
carotid artery stenosis; carotid artery stenting; carotid thrombendarterectomy; color duplex Doppler ultrasound
Hrčak ID:
98605
URI
Publication date:
4.3.2013.
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