ESVS Announces 2017 Clinical Practice Guidelines on Management of Atherosclerotic Carotid and Vertebral Disease


September 13, 2017—The European Society for Vascular Surgery (ESVS) announced the publication of the society's 2017 clinical practice guidelines on management of atherosclerotic carotid and vertebral artery disease, which is available online ahead of print in European Journal of Vascular and Endovascular Surgery. The writing group was cochaired by A. Ross Naylor, MD, and Jean-Baptiste Ricco, MD. The guidelines will be presented at the ESVS 31st annual meeting, held on September 19–22 in Lyon, France.

According to ESVS, compared to the 2009 guidelines, the document provides an updated analysis of evidence supporting the prevention of stroke in patients with asymptomatic and symptomatic carotid disease. The document outlined new features of the guidelines, which include evidence supporting the prevention of stroke in patients with atherosclerotic vertebral artery disease, sections on screening for asymptomatic carotid disease and the potential role of carotid interventions in preventing dementia, and a section on evidence supporting rapid interventions in recently symptomatic patients and the timing of interventions after thrombolysis.

Additional new sections provide evidence supporting patching, shunting, endarterectomy method, protamine reversal, treatment of coils and kinks, antegrade versus retrojugular exposure, sinus nerve blockade, and the role of monitoring; evidence supporting various carotid artery stenting techniques, including adjuvant medical therapy, wires, catheters, and stents, and cerebral protection devices; and evidence for managing complications following carotid interventions, including stroke, hypotension, hypertension, hematoma, patch infection, and restenosis.

Other new sections address the management of concurrent carotid and cardiac disease; the management of patients with asymptomatic carotid stenoses undergoing major noncardiac surgical procedures; and the management of patients with occlusive disease of the proximal common carotid artery and innominate artery.

In related news, as reported on August 30 in Endovascular Today, the European Society of Cardiology (ESC) guidelines on the diagnosis and treatment of peripheral arterial diseases, developed in collaboration with the ESVS, have been published online in European Heart Journal, European Journal of Vascular and Endovascular Surgery, and the ESC website.


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