CardioExchange Archive

October 24th, 2013

Surgery Preferable to Stents in Elderly People with Carotid Disease

Larry Husten, PHD

Age should play an important role in choosing a revascularization procedure for people with blocked carotid arteries, according to a new paper published in JAMA Surgery.  Carotid endarterectomy surgery (CEA) is preferable to carotid artery stenting (CAS) in elderly people; for younger patients, the two revascularization procedures are broadly similar. George Antoniou and colleagues analyzed data from 44 studies […]

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December 1st, 2011

Heart Over Head or Head Over Heart?

Anju Nohria, MD and James Fang, MD

A 52-year-old man presented with 3 episodes of transient dysarthria and right-sided facial numbness within a 2-week period. A carotid ultrasound revealed >70% stenosis of the left-internal carotid artery and 50%–69% stenosis of the right coronary artery. At age 40, the man had been diagnosed with non-Hodgkin lymphoma, which was treated with cranial radiation and anthracyclines, […]

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September 9th, 2011

Asymptomatic Carotid Stenosis: Medical Management or Revascularization?

Allan Brett, MD

Every so often, one of my patients with no history of stroke or transient ischemic attack asks my opinion on what to do about a carotid ultrasound — not ordered by me — showing high-grade stenosis. I am a general internist, and I don’t obtain these studies in patients without a history of cerebrovascular symptoms. Guidelines […]

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May 9th, 2011

Higher Periprocedural Risk for Stroke Found in Women Undergoing Carotid Stenting

Larry Husten, PHD

The periprocedural risk for stroke is higher among women undergoing carotid artery stenting than among those undergoing carotid endarterectomy, according to new results from the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) published online in the Lancet Neurology. The same pattern was not found in men. Last year, the main results from CREST showed no overall […]

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February 1st, 2011

New Guidelines Lend More Support for Carotid Stenting

Larry Husten, PHD

Newly issued guidelines provide increased support for carotid stenting as an alternative to carotid endarterectomy, but don’t favor widespread screening or the routine use of ultrasound to assess the risk for stroke. The Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease, developed by the AHA, the ACC, and multiple other organizations, […]

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September 27th, 2010

Carotid Endarterectomy Still Beneficial At 10 Years

Larry Husten, PHD

Carotid endarterectomy (CEA) in asymptomatic patients under 75 years of age reduces the long-term risk of stroke, according to 10-year results from the Asymptomatic Carotid Surgery Trial (ACST), published in the Lancet. The ACST investigators randomized 3120 asymptomatic patients to immediate CEA or to indefinite deferral of CEA. At 5 years, CEA had been performed […]

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