title: Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease: executive summary.
abstract: In 2008, the Society for Vascular Surgery published guidelines for the treatment of carotid bifurcation stenosis. Since that time, a number of prospective randomized trials have been completed and have shed additional light on the best treatment of extracranial carotid disease. This has prompted the Society for Vascular Surgery to form a committee to update and expand guidelines in this area. The review was done using the GRADE methodology.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be below 3% to ensure benefit for the patient. Carotid artery stenting (CAS) should be reserved for symptomatic patients with stenosis 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as first line therapy. In this Executive Summary, we only outline the specifics of the recommendations made in the six areas evaluated. The full text of these guidelines can be found on the on-line version of the Journal of Vascular Surgery at http://journals.elsevierhealth.com/periodicals/ymva.
authors: Washington Hospital Center, Georgetown University School of Medicine, Washington, DC 20010, USA. John.J.Ricotta@medstar.net
authors: John J
authors: JJ
authors: Ricotta
authors: Ali
authors: A
authors: Aburahma
authors: Enrico
authors: E
authors: Ascher
authors: Mark
authors: M
authors: Eskandari
authors: Peter
authors: P
authors: Faries
authors: Brajesh K
authors: BK
authors: Lal
mesh_terms: D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality / Q000592:standards*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D019317:Evidence-Based Medicine; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical / Q000592:standards*; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome