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While historically endarterectomy has been the treatment for carotid stenosis, stenting is an alternative intervention for patients who are not candidates for surgery. High risk factors for endarterectomy, which would favor stenting instead, include medical comorbidities (severe heart disease, heart failure, severe lung disease) and anatomic ...
Carotid endarterectomy is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (i.e., be symptomatic), or be found by a doctor in the absence of symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients.
Carotid endarterectomy: A carotid endarterectomy is a minimally invasive procedure to remove plaque from within your carotid artery, the main blood vessel that carries blood to your brain.
The surgical mortality of endarterectomy ranges from 1–2% to as much as 10%. Two large randomized clinical trials have demonstrated that carotid surgery done with a 30-day stroke and death risk of 3% or less will benefit asymptomatic people with ≥60% stenosis who are expected to live at least 5 years after surgery.
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid endarterectomy (CEA). [11] Although carotid endarterectomy is typically preferred over carotid artery stenting, stenting is indicated in select patients with radiation-induced stenosis or a carotid lesion not suitable ...
The concept was first introduced by Bailey [2] in the 1950s prior to the advent of coronary artery bypass surgery to help patients with angina and coronary artery disease. It is still used today when coronary artery bypass surgery proves difficult. Livesay [3] in Texas and Nair [4] in Leeds have published the largest series in the world.
Studies that assign aneurysm patients to treatment with EVAR or traditional open surgery have demonstrated fewer early complications with the minimally invasive approach. Some studies have also observed a lower mortality rate with EVAR. [4] [5] The reduction in death, however, does not persist long-term. After a few years, the survival after ...
Arterial and venous disease treatment by angiography, stenting, and non-operative varicose vein treatment sclerotherapy, endovenous laser treatment have largely replaced major surgery in many first world countries. These procedures provide reasonable outcomes that are comparable to surgery with the advantage of short hospital stay (day or ...
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