Indications for Revascularization in Patients with Internal Carotid Artery Stenosis

Abstract

Three different strategies should be associated for ischaemic stroke prevention in patients with internal carotid artery stenosis: vascular risk factors control, anti-thrombotic agents, and carotid revascularization. Patients are selected for carotid revascularization on the basis of the presence of clinical symptoms and degree of stenosis. The optimal indication for carotid surgery is a severe recently symptomatic stenosis, since the benefits are marginal in highgrade asymptomatic stenosis, and in moderate symptomatic stenosis. Angioplasty with endoprothesis is an alternative to surgery, but it must be restricted to symptomatic stenosis either in randomized trials, or in severe stenosis in patients in whom surgery is contra-indicated.

Key Words:

• Stroke
• cerebral ischaemia
• transient ischaemic attack
• carotid surgery.

Additional information

Notes on contributors

D. Leys

Prof. D. Leys, M.D., Ph.D. Department of Neurology Stroke Department University of Lille Roger salengro Hospital F-59037 Lille, France Tel.: [phone] Fax: [phone] E-mail: dleys@chru-lille. fr.