[Atherosclerotic carotid stenosis in women].
Atherosclerotic carotid stenosis is a risk factor for myocardial infarction, for vascular death, and for stroke. Medical treatment for atherosclerotic carotid stenosis routinely includes screening for and treatment of both risk factors and other atherosclerotic sites, the prescription of antiplatelets drugs, and patient education about transient ischemic accidents. The benefits of carotid surgery have been demonstrated in symptomatic stenoses with stenosis of 70% or more. In women, the benefits of surgery are slight for asymptomatic stenosis exceeding > 60% and for moderate symptomatic stenosis (50-69%). The treatment decision requires consideration of individual factors such as age, characteristics of the stenosis, and the type of symptoms (hemispheric or retinal). Carotid angioplasty is not yet sufficiently safe to replace endarterectomy in patients with atherosclerotic carotid stenosis. It can be proposed only after multidisciplinary consultation for patients at high risk of recurrence under medical treatment and in cases of major comorbidity contraindicating carotid surgery or of upper cervical stenosis not accessible to surgery.
Woimant
France
F
Service de neurologie, Hôpital Lariboisière, 2 rue Ambroise Paré, F-75010 Paris, France. France.woimant@lrb.aphp.fr
D017130:Angioplasty; D050197:Atherosclerosis / Q000150:complications; D016893:Carotid Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D002423:Cause of Death; D015897:Comorbidity; D004691:Endarterectomy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening; D009203:Myocardial Infarction / Q000209:etiology; D010348:Patient Care Team; D010353:Patient Education as Topic; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D015607:Stents; D020521:Stroke / Q000209:etiology; D016387:Women's Health
D010975:Platelet Aggregation Inhibitors