Guidelines for Carotid, Vertebral Artery Disease Issued

Changes in carotid artery disease screening, surgical treatment highlighted

TUESDAY, Feb. 1 (HealthDay News) -- The American Heart Association, American Stroke Association, American College of Cardiology, and other groups have issued guidelines for screening and care of extracranial carotid and vertebral artery disease; the guidelines have been published online Jan. 31 in the Journal of the American College of Cardiology.

Thomas G. Brott, M.D., from the Mayo Clinic in Jacksonville, Fla., and colleagues reviewed the literature through May 2010, and made evidence-based recommendations to help clinicians choose the most appropriate treatment with their patients.

The investigators recommend against widespread screening for carotid stenosis. People with symptoms or other stroke risk factors should be screened by ultrasound. For those with severe carotid stenosis, surgery or insertion of a stent is suggested for reducing the risk of stroke, especially when arterial narrowing is accompanied by warning symptoms of a stroke. Both carotid stenting and carotid endarterectomy are described as reasonable and safe ways of treating carotid stenosis, but medication may also be a viable alternative.

"Properly applied, rigorous, expert analysis of the available data documenting absolute and relative benefits and risks of these therapies and procedures can improve the effectiveness of care, optimize patient outcomes, and favorably affect the cost of care by focusing resources on the most effective strategies," the authors write.

Several of the committee members disclosed financial relationships with the pharmaceutical and medical device industries.

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