Preprečevanje možganskih ishemičnih dogodkov pri bolnikih s karotidno boleznijo = Prevention of ischemic brain events in patients with carotid disease
Žvan, Bojana ; Zaletel, Marjan, 1963-
Atherosclerotic carotid disease is an important cause of ischemic brain events. The first approach in the prevention of stroke is to stabilize or haltthe progression of carotid plaques via risk ...factor modification and medication. The second approach is to eliminate or reduce carotid artery stenosis through carotid endarterectomy or angioplasty with stenting. For patients with symptomatic carotid stenosis of over 70%, the value of carotid endarterectomy has been firmly established on the basis of the results of randomized trials, which showed a perioperative risk lower than 6%. The benefit of endarterectomy in patients with moderate symptomatic carotid stenosis (of 50 to 69%) has also been proved. Asymptomatic carotid stenosis isa clear risk factor for stroke, but the risk is lower than that associated with symptomatic disease. Surgical treatment of asymptomatic carotid stenosis is a source of continuing debate. At present, any decision regarding the use of endarterectomy depends on minimizing the complication rate by having an experienced surgeon (with a complication rate of less than 3%) perform the surgery. In our experience, carotid angioplasty with stenting and the use of periprocedural protection devices can be performed relatively safely with goodresults. In the conclusion, recommendations are given for the nursing of patients with ischemic brain events due to carotid stenosis.
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