Déglise Sébastien, Dubuis Céline, Mosimann Pascal, Saucy Francois, Engelberger Stefan, Hirt Lorenz, Michel Patrik, Corpataux Jean-Marc
Service de Chirurgie Thoracique et Vasculaire Division de Chirurgie Vasculaire, CHUV, Lausanne.
Rev Med Suisse. 2013 Jun 19;9(391):1305-11.
In the western world, the carotid-artery stenosis is one of the major causes of ischemic stroke in elderly people. The principal therapeutic indication is a symptomatic stenosis > 50% in the first two weeks and the surgical approach has shown the best results. Despite inferior results to carotid endarterectomy in terms of post-operative rate of stroke and/or death, except for young patients, carotid stenting remains the best choice in patients at high surgical risk. The best medical treatment, consisting in correction of cardiovascular risk factors, statin therapy and anti-aggregation led to a drastic reduction in the annual rate of stroke associated to carotid stenosis and thus limited the surgical intervention in asymptomatic patient to men with a life expectancy of at least 5 years and a stenosis > 70%.
