Medizinische Universität Graz - Research portal

Go directly to the nagivation.
Go directly to the content.

Navigation/Search

Selected Publication:

Niederkorn, K; Podreka, I; Rumpl, E; Wege, H.
Carotid endarterectomy
NEUROPSYCHIATRIE 2000 14: 23-29.
Web of Science

Leading authors Med Uni Graz: Niederkorn Kurt
Altmetrics:
Abstract:: An annual stroke incidence of 1.9 - 4% has been reported for asymptomatic carotid stenosis of more than 60% diameter reduction. In the ACAS (Asymptomatic Carotid Artery Stenosis Study) trial the risk for stroke and death over 5 years could be reduced from 11% to 5.1% by performing carotid endarterectomy (CEA) in patients with greater than 60% Internal Carotid Artery (ICA) stenosis. The existence of such a lesion, however, should not lead to a mandatory CEA. Additional factors like degree of stenosis of more than 85%, high vascular risk, clinically silent ipsilateral cerebral infarcts and rapid increase of the degree of stenosis may be helpful to identify patients who are likely to benefit from CEA. In symptomatic carotid stenosis with a diameter reduction of 70% and more, the results of the NASCET (North American Symptomatic Carotid Endarterectomy Trial) study and of the ECST (European Carotid Surgery Trial) study prove a significant risk reduction by CEA in relation to the increasing degree of stenosis. This benefit is consistent over 8 years. The NASCET results show that CEA allows a 10.1% absolute risk reduction over 5 years for 50 - 69% ICA stenosis. The indication for surgery in this group should be established on the basis of the individual case. Patients with less than 50% ICA stenosis did not benefit from surgery. In a recently published review of 2048 interventions, the method of percutaneous transluminal angioplasty with stenting (PTAS) has a technical success rate of 98.6%. The morbidity was 4.4%, the mortality 1.37%, the rate of re-stenosis at 6 months 4.8%. Prospective and randomized trials are needed to evaluate this new method in comparison with CEA. Until these multicenter trials are started. local series should be performed in well defined indications on the basis of an interdisciplinary protocol approved by the local ethics committee.
Find related publications in this database (Keywords): carotid stenosis; carotid endarterectomy; percutaneous transluminal carotis angioplasty; with stenting (PTAS)