eprintid: 10144401 rev_number: 10 eprint_status: archive userid: 699 dir: disk0/10/14/44/01 datestamp: 2022-03-02 10:29:03 lastmod: 2022-08-17 06:10:24 status_changed: 2022-03-02 10:29:03 type: article metadata_visibility: show sword_depositor: 699 creators_name: Bonati, LH creators_name: Jansen, O creators_name: de Borst, GJ creators_name: Brown, MM title: Management of atherosclerotic extracranial carotid artery stenosis ispublished: pub divisions: C07 divisions: D07 divisions: B02 divisions: UCL note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. abstract: Atherosclerosis leading to stenosis of the internal carotid artery is the underlying cause of 8–15% of ischaemic strokes (symptomatic carotid stenosis). 1–2% of the adult population have asymptomatic carotid stenosis. Clinical trials in patients with symptomatic carotid stenosis showed a higher procedural risk of non-disabling stroke with stenting versus endarterectomy, but a higher risk of myocardial infarction, cranial nerve palsy, and access site haematoma with endarterectomy. Apart from procedural complications, both treatments are equally effective in preventing stroke and recurrent severe carotid stenosis in the medium-to-long term. Endarterectomy has a modest effect in preventing stroke among patients with asymptomatic carotid stenosis, whereas the role of stenting remains to be established. With advances in medical therapy against atherosclerosis, benefit from invasive therapy has become uncertain. Risk modelling, with the inclusion of brain and carotid plaque imaging, will become increasingly important in selecting patients for interventions. date: 2022-03-01 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/S1474-4422(21)00359-8 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1942461 doi: 10.1016/S1474-4422(21)00359-8 pii: S1474-4422(21)00359-8 lyricists_name: Brown, Martin lyricists_id: MMBRO52 actors_name: Brown, Martin actors_id: MMBRO52 actors_role: owner full_text_status: public publication: The Lancet Neurology volume: 21 number: 3 pagerange: 273-283 event_location: England citation: Bonati, LH; Jansen, O; de Borst, GJ; Brown, MM; (2022) Management of atherosclerotic extracranial carotid artery stenosis. The Lancet Neurology , 21 (3) pp. 273-283. 10.1016/S1474-4422(21)00359-8 <https://doi.org/10.1016/S1474-4422%2821%2900359-8>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10144401/3/Brown_Management%20of%20atherosclerotic%20extracranial%20carotid%20artery%20stenosis_AAM.pdf