J Korean Neurol Assoc.
2012 May;30(2):77-87.
Management of Asymptomatic Carotid Stenosis for Primary Stroke Prevention: 2012 Focused Update of Korean Clinical Practice Guidelines for Stroke
- Affiliations
-
- 1Department of Neurology, Konkuk University College of Medicine, Seoul, Korea.
- 2Department of Neurosurgery, Catholic University College of Medicine, Seoul, Korea.
- 3Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
- 5Department of Neurology, Eulji University College of Medicine, Seoul, Korea.
- 6Department of Neurology, Catholic University College of Medicine, Seoul, Korea.
- 7Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea. nrhks@paik.ac.kr
- 8Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
- 9Department of Neurology, Hallym University College of Medicine, Seoul, Korea.
- 10Department of Neurology, Inha University College of Medicine, Incheon, Korea.
- 11Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
- 12Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea.
- 13Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
Abstract
- Extracranial carotid stenosis is a well-established, modifiable risk factor for stroke. Asymptomatic extracranial carotid stenosis is increasingly being detected due to the introduction of less-invasive and more-sensitive advanced diagnostic technologies. For severe asymptomatic stenosis, earlier pivotal clinical trials demonstrated the benefit of carotid endarterectomy over the best medical therapy. Since then, great advances have been made in interventional and medical therapies as well as surgical techniques. The first edition of the Korean Stroke Clinical Practice Guidelines for primary stroke prevention for the management of asymptomatic carotid stenosis reflected evidences published before June 2007. After the publication of the first edition, several major clinical trials and observational studies have been published, and major guidelines updated their recommendation. Accordingly, the writing group of Korean Stroke Clinical Practice Guidelines (CPG) decided to provide timely updated evidence-based recommendations. The Korean Stroke CPG writing committee has searched and reviewed literatures related to the management of asymptomatic carotid stenosis including published guidelines, meta-analyses, randomized clinical trials, and nonrandomized studies published between June 2007 and Feb 2011. We summarized the new evidences and revised our recommendations. Key changes in the updated guidelines are the benefit of intensive medical therapy and further evidence of carotid artery stenting as an alternative to carotid endarterectomy. The current updated guidelines underwent extensive peer review by experts from the Korean Stroke Society, Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, Korean Society of Cerebrovascular Surgery, and Korean Neurological Association. New evidences will be continuously reflected in future updated guidelines.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Stroke Update: Risk Factors and Primary Prevention of Stroke
- Review of Evidences and Updates of the Korean Clinical Practice Guidelines for Stroke in 2013
- Guideline for Extracranial Carotid Stenting: Preliminary Report
- Carotid Artery Stenting for Asymptomatic Carotid Stenosis: What We Need to Know for Treatment Decision
- Focused Update of 2009 Korean Clinical Practice Guidelines for the Surgical or Interventional treatment of Extracranial Carotid Artery Stenosis in Secondary Prevention of Stroke
