Optimal medical therapy during carotid endarterectomy: a personal view.
An important component in managing patients undergoing carotid endarterectomy (CEA) is ensuring that each receives appropriate peri-operative 'best medical therapy' as well as the assurance of a safely performed procedure. What exactly constitutes optimal medical therapy will, of course, vary both within and across health systems and has never been standardised. Accordingly, the suggestions made in this review reflect the author's personal practice and are based upon a review of the currently available evidence. The principal themes are choice of antiplatelet therapy, statin therapy, blood pressure control, choice of intra-operative heparin, the use of targeted (selective) Dextran 40 therapy postoperatively and guidelines for managing post-operative hypertension.
Naylor
A R
AR
Department of Vascular Surgery at Leicester Royal Infirmary, Leicester, UK. ross.naylor@uhl-tr.nhs.uk
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control; D007430:Intraoperative Care / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D013927:Thrombosis / Q000097:blood / Q000517:prevention & control; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors