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논문 기본 정보

자료유형
학술저널
저자정보
Baek Jang-Hyun (Department of Neurology Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Korea.Department of Neurology Severance Stroke Center Severance Hospital Yonsei University College of)
저널정보
대한신경중재치료의학회 Neurointervention Neurointervention Vol.18 No.1
발행연도
2023.3
수록면
9 - 22 (14page)
DOI
https://doi.org/10.5469/neuroint.2023.00031

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초록· 키워드

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A clinical decision on the treatment of asymptomatic carotid stenosis is challenging, unlike symptomatic carotid stenosis. Carotid artery stenting (CAS) has been recommended as an alternative to carotid endarterectomy (CEA) based on the finding that the efficacy and safety of CAS were comparable to CEA in randomized trials. However, in some countries, CAS is often performed more frequently than CEA for asymptomatic carotid stenosis. Moreover, it has been recently reported that CAS is not superior to the best medical treatment in asymptomatic carotid stenosis. Due to these recent changes, the role of CAS in asymptomatic carotid stenosis should be revisited. When determining the treatment for asymptomatic carotid stenosis, one should consider several clinical factors including stenosis degree, patient life expectancy, stroke risk by medical treatment, availability of a vascular surgeon, high risk for CEA or CAS, and insurance coverage. This review aimed to present and pragmatically organize the information that is necessary for a clinical decision on CAS in asymptomatic carotid stenosis. In conclusion, although the traditional benefit of CAS is being revisited recently, it seems too early to conclude that CAS is no longer beneficial under intense and systemic medical treatment. Instead, a treatment strategy with CAS should evolve to select eligible or medically high-risk patients more precisely.

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