Contemporary Medical Management of Carotid Artery Stenosis

• 成果类型: Review
• 署名作者: Salameh, Maya J.; Ratchford, Elizabeth V.
• 署名单位: Johns Hopkins University; Johns Hopkins Medicine
• 刊物名称: SEMINARS IN VASCULAR SURGERY
• ISSN/ISSBN: 0895-7967; 1558-4518
• DOI: 10.1053/j.semvascsurg.2026.01.001
• 发表日期: 2026-03
• 页码: 12-21
• 关键词: Carotid artery stenosis; Optimal medical therapy; stroke prevention; Antiplatelet therapy; statins; Cardiovascular risk reduction; INDIVIDUAL PARTICIPANT DATA; risk-factors; cardiovascular events; smoking-cessation; ischemic-stroke; COLLABORATIVE METAANALYSIS; myocardial-infarction; diabetes-mellitus; randomized-trials; life-style

摘要

The prevalence of carotid artery stenosis is expected to increase as the population ages. Patients with carotid disease face an elevated risk of cerebrovascular and cardiovascular (CV) complications, including stroke, transient ischemic attack, myocardial infarction, and CV death. Recommended lifestyle modifications emphasize adherence to a Mediterranean-style diet, regular physical activity, and smoking cessation, with pharmacologic support such as varenicline or combination nicotine replacement therapy as appropriate. Core medical therapies include low-dose aspirin monotherapy (or a P2Y12 receptor antagonist in cases of aspirin allergy or intolerance), high-intensity statin therapy, and blood pressure control. Patients with diabetes should be managed per current guidelines, with preference for SGLT2 inhibitors and GLP-1 receptor agonists due to their CV benefits. (c) 2026 Published by Elsevier Inc.