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Angiologia e Cirurgia Vascular

versão impressa ISSN 1646-706X

Angiol Cir Vasc v.6 n.4 Lisboa dez. 2010

 

Intervenção carotídea no doente assintomático

 

Armando Mansilha*

* Professor Auxiliar Convidado da Faculdade de Medicina do Porto

Assistente Hospitalar de Angiologia e Cirurgia Vascular no Hospital de São João

 

RESUMO

A eficácia da endarterectomia carotídea (CEA) na prevenção primária do AVC em doentes com estenose carotídea assintomática foi estabelecida nos estudos ACAS e ACST.

É uma intervenção que só se justifica se a morbilidade neurológica, morbilidade cardíaca e mortalidade associadas ao procedimento forem significativamente inferiores ao que se pode esperar com o tratamento médico isoladamente.

Este artigo procura analisar os resultados publicados que compararam a CEA com o tratamento médico apenas bem como a CEA com a técnica de stenting carotídeo (CAS) em doentes com estenose carotídea assintomática.

São também discutidas as recomendações publicadas pela European Stroke Organization (ESO) e pelas Sociedades Europeia (ESVS – European Society for Vascular Surgery) e Americana (SVS – Society for Vascular Surgery) de Cirurgia Vascular.

Palavras-chave: Estenose carotídea assintomatica, Endarterectomia, Stenting carotídeo, Tratamento médico

 

Endarterectomy and Carotid Stenting on the symptomatic patient

ABSTRACT

The efficacy of carotid endarterectomy (CEA) in preventing a stroke in patients with asymptomatic carotid stenosis has been well established in ACAS and ACST trials.

This intervention can only be justified if the perioperative stroke/myocardial infarction and death rate is lower than “best medical treatment” alone.

This review will analyse the published results comparing CEA with “best medical treatment” and also between CEA with carotid stenting (CAS) in patients with asymptomatic carotid stenosis.

It will be also analysed the recommendations published by ESVS – European Society for Vascular Surgery, SVS – Society for Vascular Surgery and ESO – European Stroke Organization.

Key words: Asymptomatic carotid stenosis, endarterectomy, carotid stenting, best medical treatment

 

Texto completo disponível apenas em PDF.

Full text only available in PDF.

 

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