SVS Guidelines for Patients: Extracranial cerebrovascular disease скачать в хорошем качестве

SVS Guidelines for Patients: Extracranial cerebrovascular disease

#CarotidStenosis #StrokePrevention #SVSGuidelines #CEA #CAS #TCR #MedicalManagement #Screening #CombinedDisease #VascularSurgery #BrainHealth This video summarises the updated Society for Vascular Surgery (SVS) guidelines for managing carotid artery stenosis, a significant stroke risk. Key recommendations include: *Asymptomatic Stenosis (more than 70%):* Carotid Endarterectomy (CEA) plus best medical therapy (BMT) is strongly recommended over BMT alone for long-term stroke prevention in low-risk patients, provided the peri-procedural stroke/death risk is under 3%. *Symptomatic Stenosis (more than 50%):* CEA is strongly recommended over transfemoral carotid artery stenting (TFCAS) due to lower immediate stroke/death risk. Transcarotid Artery Revascularization (TCR) shows promise but needs more data for first-line use. *Timing After Stroke:* For stable strokes, CEA is recommended between 48 hours and 14 days post-symptom onset. Intervention is contraindicated for disabling strokes or large infarcts due to haemorrhage risk. *Screening:* Routine general population screening is not recommended. Screening is suggested for high-risk groups (e.g., PAD, pre-CABG, older with multiple risk factors, silent strokes, bruits). Duplex ultrasound in an accredited lab is the recommended screening tool. *Combined Carotid/Coronary Disease:* For symptomatic carotid stenosis needing CABG, CEA before or concomitant with heart surgery is suggested to reduce stroke risk. This individualised decision requires a multidisciplinary team. The guidelines aim to provide evidence-based care, emphasising shared decision-making for optimal patient outcomes.