Asymptomatic carotid stenosis (ACS) carries a 4.7% risk of ipsilateral stroke if left untreated. Carotid endarterectomy (CEA) is a surgical intervention that has demonstrated efficacy in reducing stroke risk among symptomatic elderly. However, literature on its efficacy in preventing stroke in patients with ACS remains limited. Our systematic review summarizes evidence on the safety and efficacy of CEA in the asymptomatic elderly.PubMed and Scopus were searched to identify articles that described outcomes after CEA for ACS in patients aged ≥ 65 years old. Articles that did not report outcomes specific to the asymptomatic elderly were excluded. Outcomes of interest were technical success, stroke, death, myocardial infarction and post-operative complications. The Newcastle Ottawa Scale (NOS) was used to perform a qualitative assessment for risk of bias and studies with NOS ≥ 6 were considered high quality. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.After a title and abstract screen, followed by a full-text review, 7 studies reporting outcomes in 76,404 patients were included. Five studies were retrospective and two were prospective. Among studies that reported criteria for intervention in ACS patients, 2 studies performed CEA for 70% stenosis and one performed CEA for 60% stenosis. One study reported outcomes for all ranges of stenosis (mild: 0-50%, moderate: 50-79% and severe: 80-99%). Clinical outcomes varied among included studies, with rates of death stroke and myocardial infarction ranging from 0.39 to 6.1%, 0.5-1.2% and 0.9-3%, respectively.The decision to perform CEA in patients with ACS is made after outweighing risks and benefits of surgery based on various factors like age, comorbidities and frailty. At present, evidence is largely limited to retrospective studies that utilized nationwide databases. Prospective studies and randomized controlled trials could help characterize the risk of CEA in this cohort.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10143-024-03058-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A systematic review of circulating IP-10/CXCL10 in patients with Plasmodium infections in relation to disease severity.
Sci Rep
December 2024
Medical Technology Program, Faculty of Science, Nakhon Phanom University, Nakhon Phanom, Thailand.
Interferon γ-induced protein 10 kDa (IP-10) or C-X-C motif chemokine 10 (CXCL10) is produced and secreted from specific leukocytes such as neutrophils, eosinophils, and monocytes, which play key roles in the immune response to Plasmodium infections. This systematic review aimed to collate and critically appraise the current evidence on IP-10 levels in malaria patients. It provided insights into its role in malaria pathogenesis and potential as a biomarker for Plasmodium infections and disease severity.
View Article and Find Full Text PDFImmunogenicity and safety of the 15-valent pneumococcal conjugate vaccine, a systematic review and meta-analysis.
NPJ Vaccines
December 2024
Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems (Danube University Krems), Krems, Austria.
Pneumococcal infections are a serious health issue associated with increased morbidity and mortality. This systematic review evaluated the efficacy, effectiveness, immunogenicity, and safety of the pneumococcal conjugate vaccine (PCV)15 compared to other pneumococcal vaccines or no vaccination in children and adults. We identified 20 randomized controlled trials (RCTs).
View Article and Find Full Text PDFCost Outcomes of Virtual Surgical Planning in Head and Neck Reconstruction: A Systematic Review.
Head Neck
December 2024
Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Background: Virtual surgical planning (VSP) is an emerging method in head and neck reconstruction with demonstrated benefits, however, its economic viability is supported with mixed evidence.
Methods: A structured search was performed in five electronic databases. Studies that performed an economic evaluation on VSP in head and neck reconstruction were included.
Clinical presentations and complications of lichen sclerosus: A systematic review.
J Dtsch Dermatol Ges
December 2024
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Lichen sclerosus (LS) is a chronic, inflammatory dermatosis most commonly characterized by changes in skin pigmentation and pruritus, with associated dyspareunia and genital architectural changes. There are a variety of complications associated with LS, which further worsen a patient's health-related quality of life. A systematic review was conducted to summarize the literature regarding clinical features of LS, as well as LS-associated complications.
View Article and Find Full Text PDFIs transoral robotic surgery useful as a salvage technique in head and neck cancers: a systematic review and meta analysis.
Head Neck
December 2024
Department of Otolaryngology Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, Australia.
Background: Residual, recurrent, and second primary head and neck cancers are on the rise. This is largely driven by a younger age at diagnosis and increasingly targeted chemoradiotherapy options. Salvage surgery remains the only curative intent option in this cohort of patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!