Comparative Review of the Treatment Methodologies of Carotid XXXX .

@entity1 @entity64 @entity6 @entity1397 @entity117 @entity3538 @entity6817 @entity2998 @entity850 @entity543 @entity204
The treatment of @entity543 entails three methodologies, namely, medical management, @entity3538 ( @entity3538 ), as well as carotid endarterectomy (CEA). The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) have shown that symptomatic @entity543 greater than 70% is best treated with CEA. In asymptomatic @entity1 with @entity543 greater than 60%, CEA was more beneficial than treatment with @entity117 alone according to the Asymptomatic @entity2998 (ACAS) and Asymptomatic Carotid @entity850 Trial (ACST) trials. When @entity3538 is compared with CEA, the CREST resulted in similar rates of @entity64 and @entity204 rates regardless of symptoms. However, @entity3538 not only increased adverse effects in @entity1 , it also amplified @entity64 rates and @entity204 in elderly @entity1 compared with CEA. @entity3538 can maximize its utility in treating focal restenosis after CEA and @entity1 with overwhelming cardiac risk or prior neck irradiation. When performing CEA, using a patch was equated to a more durable result than primary closure, whereas eversion technique is a new methodology deserving a spotlight. Comparing the three major treatment strategies of @entity543 has intrinsic drawbacks, as most trials are outdated and they vary in their premises, definitions, and study designs. With the newly codified best medical management including antiplatelet therapies with @entity117 and @entity1397 , @entity6817 , antihypertensive agents, strict @entity6 control, smoking cessation, and life style change, the current trials may demonstrate that asymptomatic @entity543 is best treated with best medical therapy. The ongoing trials will illuminate and reshape the treatment paradigm for symptomatic and asymptomatic @entity543 .
