Medical treatment in carotid artery intervention

J. L. Kolkert, R. Meerwaldt, J. D. Lefrandt, R. H. Geelkerken, C. J. Zeebregts*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Medical treatment has a pivotal role in the treatment of patients with occlusive carotid artery disease. Large trials have provided the justification for operative treatment besides medical treatment in patients with recent significant carotid artery stenosis two decades ago. Since then, medical therapy has evolved tremendously. Next to aspirin, antiplatelet regimens acting on a different level in the modulation of platelet aggregation have made their entry. Moreover, statin therapy has been introduced. These changes among others in secondary stroke prevention, along with better understanding in life-style adjustments and perioperative medical management, have led to a decrease in stroke recurrence. Secondary prevention is therefore now the most important pillar of medical therapy. It consists of antiplatelet therapy, statins and blood pressure lowering agents in all patients. Small adjustments are recommended for those patients referred for invasive treatment. Moreover, long-term medical treatment is imperative. In this article, we summarize current evidence in literature regarding medical management in patients with previous stroke or TIA.

Original languageEnglish
Pages (from-to)803-819
Number of pages17
JournalJournal of Cardiovascular Surgery
Volume52
Issue number6
Publication statusPublished - 1 Dec 2011
Externally publishedYes

Keywords

  • Angioplasty
  • Aspirin
  • Carotid stenosis
  • Endarterectomy, carotid

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