By Rohit Khurana BMBCH, PhD, Philip Teal MD (auth.), Jacqueline Saw (eds.)
Over the earlier 3 a long time, carotid artery stenting has advanced to develop into a promising and manageable substitute to carotid endarterectomy, in particular for sufferers deemed to have excessive surgical dangers. In Carotid Artery Stenting: the fundamentals, Jacqueline observed and a panel of overseas specialists on carotid artery stenting talk about extensive the main points of all modern elements of carotid stenting, whereas reviewing helping stories, instructions, technical views, and peri-procedural administration. This textbook serves as a studying source at the multifaceted administration of sufferers with carotid artery stenosis, with the most important specialise in extracranial carotid artery stenting. extra sections element the specifics of developing and keeping a laboratory and talk about the guidance of the carotid artery stenting technique from either the sufferer and operator’s viewpoint. Authoritative and hugely useful, Carotid Artery Stenting: the fundamentals is an obtainable consultant and important source for today’s cardiologists, radiologists, and vascular surgeons.
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Extra info for Carotid Artery Stenting: The Basics
On the other hand, the mortality and risk of stroke at CEA is 20% in the presence of stroke in evolution or crescendo TIA (13). Hence, this remains a subject of debate. Particular steps in the preoperative management of patients planning to undergo CEA include the appropriate antiplatelet medication. Aspirin therapy is continued in the perioperative period. Anticoagulation with heparin should be considered prior to CEA for high-grade stenosis and symptoms (acute stroke or crescendo TIA) to prevent another ischemic episode or complete arterial occlusion (14, 15).
Patients are usually discharged home on the first or second postoperative day if no complication occurs. They are continued on their antiplatelet and secondary preventative therapy. Postoperatively, a carotid duplex should be performed at 2–6 weeks after CEA. If satisfactory, another duplex should be done 6 months to 1 year later, then every year subsequently. If there is evidence of moderate contralateral disease or recurrent stenosis, scanning may be performed at 6–12 month intervals (29). Shunting or Not No randomized trials have been conducted that demonstrate superiority of shunting (30), although routine shunt insertion is known to have low perioperative death and stroke rates (31).
Ogasawara K, Yukawa H, Kobayashi M, Mikami C, Konno H, Terasaki K, Inoue T, Ogawa A. Prediction and monitoring of cerebral hyperperfusion after carotid endarterectomy by using single-photon emission computerized tomography scanning. J Neurosurg 2003;99:504–510. 77. Solomon RA, Loftus CM, Quest DO, Correll JW. Incidence and etiology of intracerebral hemorrhage following carotid endarterectomy. J Neurosurg 1986;64:29–34. 78. Schroeder T, Sillesen H, Boesen J, Laursen H, Sorensen P. Intracerebral haemorrhage after carotid endarterectomy.