Kirurgi vid asymtomatisk karotisstenos ifrågasätts nu. Kanske räcker det med modern läkemedelsbehandling
Engelsk titel: Surgery in asymptomatic carotid stenosis now questioned. Perhaps can current drug therapy be enough
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Författare:
Gottsäter, Anders
;
Mätzsch, Thomas
Email: matzsch@gmail.com
Språk: Swe
Antal referenser: 44
Dokumenttyp:
Översikt
UI-nummer: 10111228
Sammanfattning
Two large randomized studies have shown that carotid endarterectomy could halve the risk of stroke in patients < 75 years of age with asymptomatic carotid artery stenosis. Out of 22 Swedish centres performing carotid surgery, 73 % also operates upon asymptomatic patients. The quality of pharmacological treatment in patients with asymptomatic carotid artery stenosis has improved, and decreasing stroke incidence has been attributed to this improved medical treatment. Conclusive data on causal relations are still lacking, however. The indication for surgery has been questioned and should probably be discussed further. In the absence of conclusive studies, this article proposes selection criteria for surgery in patients with asymptomatic carotid artery stenosis, such as age, plaque morphology and concomitant disease.