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J Neurol Neurosurg Psychiatry 2005;76:1332-1336 doi:10.1136/jnnp.2005.066936
  • Review

Management of asymptomatic carotid stenosis in patients undergoing general and vascular surgical procedures

  1. M Paciaroni1,
  2. V Caso1,
  3. M Acciarresi1,
  4. R W Baumgartner2,
  5. G Agnelli1
  1. 1Stroke Unit, University Hospital of Perugia, Italy
  2. 2Department of Neurology, University Hospital of Zürich, Switzerland
  1. Correspondence to:
 Dr M Paciaroni
 Stroke Unit, University of Perugia, Ospedale Silvestrini, Sant’Andrea delle Fratte, Perugia 06126, Italy; mpaciaronilibero.it
  • Received 6 March 2005
  • Accepted 1 May 2005
  • Revised 22 April 2005

Abstract

Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of <3% with unilateral asymptomatic stenosis >60% or bilateral carotid stenosis >75% on the same side as the most severe stenosis. Clarification of the optimal strategy requires an adequately powered, multicentre, randomised clinical trial.

Footnotes

  • Competing interests: none declared

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