Why selective screening for asymptomatic carotid stenosis is currently appropriate: a special report
Year: 2024
Type: review
Abstract: INTRODUCTION: Two of the main reasons recent guidelines do not recommend routine population-wide screening programs for asymptomatic carotid artery stenosis (AsxCS) is that screening could lead to an increase of carotid revascularization procedures and that such mass screening programs may not be cost-effective. Nevertheless, selective screening for AsxCS could have several benefits. This article presents the rationale for such a program. AREAS COVERED: The benefits of selective screening for AsxCS include early recognition of AsxCS allowing timely initiation of preventive measures to reduce future myocardial infarction (MI), stroke, cardiac death and cardiovascular (CV) event rates. EXPERT OPINION: Mass screening programs for AsxCS are neither clinically effective nor cost-effective. Nevertheless, targeted screening of populations at high risk for AsxCS provides an opportunity to identify these individuals earlier rather than later and to initiate a number of lifestyle measures, risk factor modifications, and intensive medical therapy in order to prevent future strokes and CV events. For patients at 'higher risk of stroke' on best medical treatment, a prophylactic carotid intervention may be considered.
Authors: Kosmas I. Paraskevas, Alan Dardik, Marc L. Schermerhorn, Christos D. Liapis, Armando Mansilha, Brajesh K. Lal, William A. Gray, Martin M. Brown, Piotr Myrcha, Carl J. Lavie, Clark J. Zeebregts, Eric A. Secemsky, Luca Saba, Matthew Blecha, Victor Gurevich, Mauro Silvestrini, Ales Blinc, Alexei Svetlikov, Jose Fernandes e Fernandes, Peter A. Schneider, Peter Gloviczki, Christopher J. White, Ali F. AbuRahma
Institutions: Hellenic Red Cross, Red Cross Hospital, Yale University, VA Connecticut Healthcare System, Beth Israel Deaconess Medical Center, Harvard University, Universidade do Porto, Hospital de São João, University of Maryland, Baltimore, Mayo Clinic, Baltimore VA Medical Center, Lankenau Heart Institute, UCL Queen Square Institute of Neurology, University College London, Medical University of Warsaw, The University of Queensland, Ochsner Medical Center, University Medical Center Groningen, University of Groningen, Azienda Ospedaliero-Universitaria Cagliari, Loyola University Chicago, St Petersburg University, Marche Polytechnic University, University of Ljubljana, Ljubljana University Medical Centre, Federal Medical-Biological Agency, University of Lisbon, Hospital da Luz, University of California, San Francisco, West Virginia University, Charleston Area Medical Center
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4392814932