Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease: Executive summary

作者：Ricotta John J^*; AbuRahma All; Ascher Enrico; Eskandari Mark; Faries Peter; Lal Brajesh K

来源：Journal of Vascular Surgery, 2011, 54(3): 832-836.

DOI：10.1016/j.jvs.2011.07.004

In 2008, the Society for Vascular Surgery published guidelines for the treatment of carotid bifurcation stenosis. Since that time, a number of prospective randomized trials have been completed and have shed additional light on the best treastment of extracranial carotid disease. This has prompted the Society for Vascular Surgery to form a committee to update and expand guidelines in this area. The review was done using the GRADE methodology.
In contrast to the multispecialty guidelines recently published, the committee recommends carotid endarterectomy (CEA) as first line treatment for most symptomatic patients with stenosis 50% to 99% and asymptomatic patients with stenosis 60% to 99%. The perioperative risk of stroke and death in asymptomatic patients must be below 3% to ensure benefit for the patient. Carotid artery stenting (CAS) should be reserved for symptomatic patients with stenosis 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as first line therapy.
In this Executive Summary, we only outline the specifics of the recommendations made in the six areas evaluated. The full text of these guidelines can be found on the on-line version of the Journal of Vascular Surgery at http://journals.elsevierhealth.com/periodicals/ymva. (J Vasc Surg 2011;54:832-6.)

• 出版日期2011-9
• 单位西北大学