[Treatment of carotid stenosis: angioplasty, a well thought-out choice].
FOUR THERAPEUTIC CLASSES FOR SECONDARY PREVENTION: These are statins (benefit comparable to that obtained following myocardial infarction or stroke), antiplatelet drugs, basically aspirin, clopidogrel that currently has no place in first-line treatment, converting enzyme inhibitors and beta-blockers. There is currently insufficient data to recommend the routine use of vasoactive agents in patients presenting with claudication. IN THE CASE OF CRITICAL ISCHAEMIA: When faced with this serious situation, one must control the pain and the infection and, all cases, revascularisation should be attempted. Amputation should be proposed in the case of trophic disorders and gangrene. ANGIOGENESIS, A POSSIBLE ALTERNATIVE: This is defined by the budding, from existing vessels, of new vessels under the impact of growth and stabilising factors. It is possible to distinguish arteriogenesis with development of pre-existing collateral vessels, angiogenesis itself that corresponds to the development of small vessels from the large vessels and vasculogenesis, which is the formation of new vessels mediated by circulating endothelial progenitors.
Emmerich
Joseph
J
Service de médecine vasculaire, Inserm U428, Hôpital européen Georges Pompidou, Paris.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use; D017130:Angioplasty; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D043925:Angiogenesis Inducing Agents; D000806:Angiotensin-Converting Enzyme Inhibitors; D010975:Platelet Aggregation Inhibitors