Risk-Benefit Assessment of Carotid Revascularization
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos Brasileiros de Cardiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018001600618 |
Resumo: | Abstract Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of a periprocedural risk of less than 6% in symptomatic patients. The medical therapy significantly reduced the revascularization net benefit ratio for stroke prevention in asymptomatic patients. Real life registries indicate that carotid stenting is associated with a greater periprocedural risk. The operator annual procedure volume and patient age has an important influence in the rate of stroke and death after carotid stenting. Symptomatic patients have a higher incidence of death and stroke after the procedure. Revascularization has the greatest benefit in the first weeks of the event. There is a discrepancy in the scientific literature about carotid revascularization and/or clinical treatment, both in primary and secondary prevention of patients with carotid artery injury. The identification of patients who will really benefit is a dynamic process subject to constant review. |
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Risk-Benefit Assessment of Carotid RevascularizationCarotid Artery DiseasesAtherosclerosisEndarterectomy, CarotidStrokeIndicators of Morbidity and MortalityRisk AssessmentAbstract Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of a periprocedural risk of less than 6% in symptomatic patients. The medical therapy significantly reduced the revascularization net benefit ratio for stroke prevention in asymptomatic patients. Real life registries indicate that carotid stenting is associated with a greater periprocedural risk. The operator annual procedure volume and patient age has an important influence in the rate of stroke and death after carotid stenting. Symptomatic patients have a higher incidence of death and stroke after the procedure. Revascularization has the greatest benefit in the first weeks of the event. There is a discrepancy in the scientific literature about carotid revascularization and/or clinical treatment, both in primary and secondary prevention of patients with carotid artery injury. The identification of patients who will really benefit is a dynamic process subject to constant review.Sociedade Brasileira de Cardiologia - SBC2018-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018001600618Arquivos Brasileiros de Cardiologia v.111 n.4 2018reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20180208info:eu-repo/semantics/openAccessOliveira,Pedro Piccaro deVieira,José Luiz da CostaGuimarães,Raphael BoescheAlmeida,Eduardo DytzSavaris,Simone LouisePortal,Vera Luciaeng2018-10-18T00:00:00Zoai:scielo:S0066-782X2018001600618Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2018-10-18T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Risk-Benefit Assessment of Carotid Revascularization |
title |
Risk-Benefit Assessment of Carotid Revascularization |
spellingShingle |
Risk-Benefit Assessment of Carotid Revascularization Oliveira,Pedro Piccaro de Carotid Artery Diseases Atherosclerosis Endarterectomy, Carotid Stroke Indicators of Morbidity and Mortality Risk Assessment |
title_short |
Risk-Benefit Assessment of Carotid Revascularization |
title_full |
Risk-Benefit Assessment of Carotid Revascularization |
title_fullStr |
Risk-Benefit Assessment of Carotid Revascularization |
title_full_unstemmed |
Risk-Benefit Assessment of Carotid Revascularization |
title_sort |
Risk-Benefit Assessment of Carotid Revascularization |
author |
Oliveira,Pedro Piccaro de |
author_facet |
Oliveira,Pedro Piccaro de Vieira,José Luiz da Costa Guimarães,Raphael Boesche Almeida,Eduardo Dytz Savaris,Simone Louise Portal,Vera Lucia |
author_role |
author |
author2 |
Vieira,José Luiz da Costa Guimarães,Raphael Boesche Almeida,Eduardo Dytz Savaris,Simone Louise Portal,Vera Lucia |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Oliveira,Pedro Piccaro de Vieira,José Luiz da Costa Guimarães,Raphael Boesche Almeida,Eduardo Dytz Savaris,Simone Louise Portal,Vera Lucia |
dc.subject.por.fl_str_mv |
Carotid Artery Diseases Atherosclerosis Endarterectomy, Carotid Stroke Indicators of Morbidity and Mortality Risk Assessment |
topic |
Carotid Artery Diseases Atherosclerosis Endarterectomy, Carotid Stroke Indicators of Morbidity and Mortality Risk Assessment |
description |
Abstract Severe carotid atherosclerotic disease is responsible for 14% of all strokes, which result in a high rate of morbidity and mortality. In recent years, advances in clinical treatment of cardiovascular diseases have resulted in a significant decrease in mortality due to these causes. To review the main studies on carotid revascularization, evaluating the relationship between risks and benefits of this procedure. The data reviewed show that, for a net benefit, carotid intervention should only be performed in cases of a periprocedural risk of less than 6% in symptomatic patients. The medical therapy significantly reduced the revascularization net benefit ratio for stroke prevention in asymptomatic patients. Real life registries indicate that carotid stenting is associated with a greater periprocedural risk. The operator annual procedure volume and patient age has an important influence in the rate of stroke and death after carotid stenting. Symptomatic patients have a higher incidence of death and stroke after the procedure. Revascularization has the greatest benefit in the first weeks of the event. There is a discrepancy in the scientific literature about carotid revascularization and/or clinical treatment, both in primary and secondary prevention of patients with carotid artery injury. The identification of patients who will really benefit is a dynamic process subject to constant review. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018001600618 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018001600618 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/abc.20180208 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia - SBC |
dc.source.none.fl_str_mv |
Arquivos Brasileiros de Cardiologia v.111 n.4 2018 reponame:Arquivos Brasileiros de Cardiologia (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
Arquivos Brasileiros de Cardiologia (Online) |
collection |
Arquivos Brasileiros de Cardiologia (Online) |
repository.name.fl_str_mv |
Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
||arquivos@cardiol.br |
_version_ |
1752126568614854656 |