Optimal periprocedural antithrombotic treatment in carotid interventions: An international, multispecialty, expert review and position statement

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Armando Amilcar Pires Mansilha Rodrigues De Almeida

    Autor

Participantes de fora da FMUP

  • Paraskevas, KI
  • Gloviczki, P
  • Mikhailidis, DP
  • Antignani, PL
  • Dardik, A
  • Eckstein, HH
  • Faggioli, G
  • Fernandes, JFE
  • Fraedrich, G
  • Gupta, A
  • Jawien, A
  • Jezovnik, MK
  • Kakkos, SK
  • Knoflach, M
  • Lal, BK
  • Lanza, G
  • Liapis, CD
  • Loftus, IM
  • Millon, A
  • Pini, R
  • Poredos, P
  • Proczka, R
  • Ricco, JB
  • Rundek, T
  • Saba, L
  • Schlachetzki, F
  • Silvestrini, M
  • Spinelli, F
  • Stilo, F
  • Suri, JS
  • Zeebregts, CJ
  • Lavie, CJ
  • Chaturvedi, S

Unidades de investigação

Abstract

Background: The optimal antithrombotic (antiplatelet or anticoagulant) treatment of patients undergoing extracranial carotid artery interventions is a subject of debate. The aim of this multidisciplinary document was to critically reviewthe recommendations of current guidelines, taking into consideration the results of recently published studies. Methods: The various antithrombotic strategies reported were evaluated for asymptomatic and symptomatic patients undergoing extracranial carotid artery interventions (endarterectomy, transfemoral carotid artery stenting [CAS] or transcarotid artery revascularization [TCAR]). Based on a critical review, a series of recommendations were formulated by an international expert panel. Results: For asymptomatic patients, we recommend low-dose aspirin (75-100 mg/day) or clopidogrel (75 mg/day) with the primary goal to reduce the risk of myocardial infarction and cardiovascular event rates rather than to reduce the risk of stroke. For symptomatic patients, we recommend dual antiplatelet treatment (DAPT) initiatedwithin 24 h of the index event to reduce the risk of recurrent events. We suggest that following transfemoral CAS or TCAR, patients continue DAPT for 1 month after which a single antiplatelet agent is used. High level of evidence to support anticoagulant treatment for patients with carotid artery disease is lacking. Conclusions: The antithrombotic treatment offered to carotid patients should be individualized, taking into account the presence of symptoms, the type of intervention and the goal of the treatment. The duration and type of DAPT (ticagrelor instead of clopidogrel) should be evaluated in future trials. (c) 2022 Elsevier Inc. All rights reserved.

Copyright © 2022 Elsevier Inc. All rights reserved.

Dados da publicação

ISSN/ISSNe:
1873-1740, 0033-0620

Progress in Cardiovascular Diseases  W.B. Saunders Ltd

Tipo:
Review
Páginas:
28-37
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 3

Citações Recebidas na Scopus: 4

Documentos

  • Não há documentos

Métricas

Filiações mostrar / ocultar

Keywords

  • Carotid endarterectomy; Carotid artery stenting; TCAR; Aspirin; Clopidogrel; Antithrombotic treatment; Stroke

Proyectos asociados

Endovascular Treatment of Aortic Arch Aneurysms

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico (Aneurysms) . 2020

The role of infrared thermography in predicting diabetic foot outcomes

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico (diabetic foot) . 2021

Endovascular solutions for type IA endoleak after endovascular aneurysm repair

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico . 2021

Intermittent Claudication: Importance of Supervised Exercise Programme

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico . 2021

Endovascular Aneurysm Repair - Strategies and Outcomes in Hostile Anatomies

Investigador Principal: Armando Amilcar Pires Mansilha Rodrigues de Almeida

Estudo Clínico Académico . 2022

Citar a publicação

Partilhar a publicação