The fate of asymptomatic severe carotid stenosis in the era of best medical therapy

<p><i>Background</i>: Medical therapy for asymptomatic carotid artery stenosis (ACAS) may obviate the carotid revascularization, according to recent literature reports, but many studies also considered moderate carotid artery stenosis (50–69% NASCET). This study reviews the most recent series of ACAS focusing on ipsilateral transient ischemic attack (TIA) stroke and annual risk of stroke in patients with ACAS ≥70%, thereby also evaluating the adherence to best medical therapy (BMT). <i>Methods</i>: A systematic review consisting of all the series of patients with ACAS being treated medically was performed, which was published after 2005. The annual pooled risk of ipsilateral TIA-stroke and stroke in patients with ACAS ≥70% was calculated. A subgroup of studies with BMT defined as ≥90% of the patients in antiplatelet and statin therapy was performed. <i>Results</i>: Eleven studies, with the enrolling period from 1996 to 2009, were reviewed. Overall, 2185 patients were considered, with a follow-up from 2 to 13 years, for a total of 6834 patients/year. The pooled risk was 3.4%/year for ipsilateral TIA-stroke and 1.6%/year for stroke. Five studies, published from 2014, had BMT adherence, for a total of 1665 patients/year. The pooled risk was 3.5%/year for ipsilateral TIA-stroke and for stroke. <i>Conclusion</i>: The most recent series of ACAS ≥70% and BMT had an overall stroke rate which is relatively low; however, the risk of developing symptoms is still relevant (3.4%/year).</p

sj-docx-1-jet-10.1177_15266028231162258 – Supplemental material for Renal Benefits of CO2 as a Contrast Media for EVAR Procedures: New Perspectives on 1 Year Outcomes

Supplemental material, sj-docx-1-jet-10.1177_15266028231162258 for Renal Benefits of CO2 as a Contrast Media for EVAR Procedures: New Perspectives on 1 Year Outcomes by Marco Busutti, Alice Sensoni, Andrea Vacirca, Chiara Abenavoli, Chiara Donadei, Anna Laura Croci Chiocchini, Matteo Righini, Giorgia Comai, Alessia Pini, Gianluca Faggioli, Enrico Gallitto, Gaetano La Manna and Mauro Gargiulo in Journal of Endovascular Therapy</p