Management of Patients Undergoing Carotid Artery Stenting: Difference between revisions
(Created page with "__NOTOC__ {{Carotid artery stenosis}} {{CMG}} ==Management of Patients Undergoing Carotid Artery Stenting== ===2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM...") |
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Before and for a minimum of 30 days after CAS, [[antiplatelet|dual | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Before and for a minimum of 30 days after CAS, [[antiplatelet|dual antiplatelet therapy]] with [[aspirin]] (81 to 325 mg daily) plus [[clopidogrel]] (75 mg daily) is recommended. For patients intolerant of clopidogrel, [[ticlopidine]] (250 mg twice daily) may be substituted'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Administration of antihypertensive medication is recommended to control blood pressure before and after CAS ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Administration of antihypertensive medication is recommended to control blood pressure before and after CAS ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' The findings on clinical neurological examination should be | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' The findings on clinical neurological examination should be documented within 24 hours before and after CAS ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Embolic protection device (EPD) deployment during CAS can be beneficial to reduce the risk of [[stroke]] when the risk of vascular injury | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Embolic protection device (EPD) deployment during CAS can be beneficial to reduce the risk of [[stroke]] when the risk of vascular injury low'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Noninvasive imaging of the extracranial carotid arteries is reason- able 1 month, 6 months, and annually after revascularization to assess patency and exclude the development of new or | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Noninvasive imaging of the extracranial carotid arteries is reason- able 1 month, 6 months, and annually after revascularization to assess patency and exclude the development of new or contralateral lesions. Once stability has been established over an extended period, surveillance at extended intervals may be appropriate. Termination of surveillance is reasonable when the patient is no longer a candidate for intervention ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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==References== | ==References== |
Latest revision as of 19:46, 31 October 2016
Carotid artery stenosis Microchapters |
Diagnosis |
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Treatment |
ACC/AHA Guideline Recommendations |
Periprocedural Management of Patients Undergoing Carotid Endarterectomy |
Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease |
Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
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Risk calculators and risk factors for Management of Patients Undergoing Carotid Artery Stenting |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Management of Patients Undergoing Carotid Artery Stenting
2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)[1]
Recommendations for Management of Patients Undergoing Carotid Artery Stenting
Class I |
"1. Before and for a minimum of 30 days after CAS, dual antiplatelet therapy with aspirin (81 to 325 mg daily) plus clopidogrel (75 mg daily) is recommended. For patients intolerant of clopidogrel, ticlopidine (250 mg twice daily) may be substituted (Level of Evidence: C) " |
"2. Administration of antihypertensive medication is recommended to control blood pressure before and after CAS (Level of Evidence: C) " |
"3. The findings on clinical neurological examination should be documented within 24 hours before and after CAS (Level of Evidence: C) " |
Class IIa |
"1. Embolic protection device (EPD) deployment during CAS can be beneficial to reduce the risk of stroke when the risk of vascular injury low (Level of Evidence: C)" |
"2. Noninvasive imaging of the extracranial carotid arteries is reason- able 1 month, 6 months, and annually after revascularization to assess patency and exclude the development of new or contralateral lesions. Once stability has been established over an extended period, surveillance at extended intervals may be appropriate. Termination of surveillance is reasonable when the patient is no longer a candidate for intervention (Level of Evidence: C)" |
References
- ↑ Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL; et al. (2011). "2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery". Circulation. 124 (4): 489–532. doi:10.1161/CIR.0b013e31820d8d78. PMID 21282505.