Carotid artery stenosis medical therapy

Carotid artery stenosis Microchapters
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Selection of Patients for Carotid Revascularization
Periprocedural Management of Patients Undergoing Carotid Endarterectomy
Management of Patients Undergoing Carotid Artery Stenting
Restenosis After Carotid Endarterectomy or Stenting
Vascular Imaging in Patients With Vertebral Artery Disease
Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease
Occlusive Disease of the Subclavian and Brachiocephalic Arteries
Fibromuscular Dysplasia
Cervical Artery Dissection
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Medical Therapy

• Conservative treatment can include the use of Antiplatelet drugs

Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Treatment of Hypertension (DO NOT EDIT)

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Class I Antihypertensive treatment is recommended for patients with hypertension and asymptomatic atherosclerotic ECVD to maintain blood pressure (BP) less than 140/90 mmHg. (Level of Evidence: A) Class IIa Except during the hyperacute period, antihypertensive treatment is probably indicated in patients with hypertension and symptomatic atherosclerotic ECVD, but the benefit of treatment to a specific BP has not been established in relation to the risk of exacerbating cerebral ischemia. (Level ofEvidence: C)

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Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease:Control of Hyperlipidemia (DO NOT EDIT)

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Class I Treatment with a statin is recommended for all patients with atherosclerotic ECVD to lower lowdensity lipoprotein cholesterol to less than 100 mg/dL. (Level of Evidence: B) Class IIa Treatment with a statin is reasonable for all patients with atherosclerotic ECVD who sustain ischemic stroke to reduce low-density lipoprotein cholesterol to a level less than or equal to 70 mg/dL. (Level of Evidence: B) If treatment with a statin does not achieve the goal, intensifying therapy with an additional drug from among those with evidence of improving outcomes can be effective. (Level of Evidence: B) For patients who do not tolerate statins, therapy with bile acid sequestrants and/or niacin is reasonable. (Level of Evidence: B)

”

Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Management of Diabetes Mellitus in Patients With Atherosclerosis of the Extracranial Carotid or Vertebral Arteries (DO NOT EDIT)

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Class IIa Diet, exercise, and glucose-lowering drugs can be useful for patients with diabetes mellitus and extracranial carotid or vertebral artery atherosclerosis. The stroke prevention benefit, however, of intensive glucose lowering therapy to a glycosylated hemoglobin A1c level less than 7.0% has not been established. (Level of Evidence: A) Administration of statin-type lipid-lowering medication at a dosage sufficient to reduce LDL cholesterol to a level near or below 70 mg/dL is reasonable in patients with diabetes mellitus and extracranial carotid or vertebral artery atherosclerosis for prevention of ischemic stroke and other ischemic cardiovascular events. (Level of Evidence: B)

”