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A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis

 E-Wook Jang  ;  Joonho Chung  ;  Kwon-Duk Seo  ;  Sang Hyun Suh  ;  Yong Bae Kim  ;  Kyung-Yul Lee 
 Journal of Cerebrovascular and Endovascular Neurosurgery, Vol.17(2) : 101-107, 2015 
Journal Title
 Journal of Cerebrovascular and Endovascular Neurosurgery 
Issue Date
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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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실)
Yonsei Authors
김용배(Kim, Yong Bae) ORCID logo https://orcid.org/0000-0003-2262-7157
서권덕(Seo, Kwon Duk)
서상현(Suh, Sang Hyun) ORCID logo https://orcid.org/0000-0002-7098-4901
이경열(Lee, Kyung Yul) ORCID logo https://orcid.org/0000-0001-5585-7739
장이욱(Jang, E Wook)
정준호(Chung, Joon Ho)
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