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KMID : 1005420150170010101
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Journal of Cerebrovascular and Endovascular Neurosurgery
2015 Volume.17 No. 1 p.101 ~ p.107
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Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis
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Jang E-Wook
Chung Joon-Ho
Seo Kwon-Duk
Suh Sang-Hyun
Kim Yong-Bae
Lee Kyung-Yul
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Abstract
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Objective:There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis.
Materials and Methods:A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established.
Results:CEA or CAS is indicated when the patient has a symptomatic stenosis ≥ 50%, or when the patient has an asymptomatic stenosis ≥ 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected.
Conclusion:We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.
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KEYWORD
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Carotid artery stenosis, Carotid artery stenting, Carotid endarterectomy, Protocol
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