Management of Patients Undergoing Carotid Artery Stenting

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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)

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

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