Kirurgi snart även primärprevention vid slaganfall av höggradig karotisstenos

Abstract

Indications for and the results of carotid endarterectomy in symptomatic and asymptomatic carotid artery stenosis are reviewed. The main indication for carotid endarterectomy is symptomatic stenosis of a carotid artery with >70 percent lumen reduction according to the NASCET method, or >85 percent lumen reduction according to the ECST method. The operation should ideally be performed within two weeks after the onset of symptoms. Preliminary results from the ACST study, indicating significant beneficial effects of carotid endarterectomy also in asymptomatic carotid artery stenosis have been orally presented. Assessment of and surgery upon Swedish patients with significant carotid artery stenosis should be performed in specialised multidisciplinary »carotid artery centers«. Endovascular treatment of carotid artery stenosis should at the present stage only be performed within clinical trials