From the middle of the 20th century the carotid operations widespreaded all over the world. After the difficulties of the early periode standard technics have been developed. The results of the endarterectomies improved and the operative indications due to the neurological stages have been precised. The results of the international prospective, multicentric, randomised studies in North America and Europe, based on data of several thousand patients, showed evidences for the role of the operations in prevention of stroke, defining the indication for surgery depending on the morphology of the cartoid bifurcation and the neurological stage of the patients. It became evident that the results of the operations in case of carotid stenosis >70% are better than the results of the best medical treatment either in asymptomatic or in symptomatic groups. From the past decade the carotid stenting became widely used in the prevention of stroke, although the results of the international studies are controversal, so threre is a need for new studies. In the present time we conclude, based of our experiences as well, that the carotid stenting is a safe procedure only in hands of a well experienced operator. There are some morphological criteria where stenting is contraindicated. Carotid surgery and stenting are two modalities helping each other, but the gold standard is still the operation.
|Translated title of the contribution||Carotid surgery|
|Number of pages||6|
|Publication status||Published - Dec 1 2009|
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