Piotr Musialek
Stroke risk management in carotid atherosclerotic disease: A Clinical Consensus Statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases
Musialek, Piotr; Bonati, Leo H; Bulbulia, Richard; Halliday, Alison; Bock, Birgit; Capoccia, Laura; Eckstein, Hans-Henning; Grunwald, Iris Q; Lip, Peck Lin; Monteiro, Andre; Paraskevas, Kosmas I; Podlasek, Anna; Rantner, Barbara; Rosenfield, Kenneth; Siddiqui, Adnan H; Sillesen, Henrik; Van Herzeele, Isabelle; Guzik, Tomasz J; Mazzolai, Lucia; Aboyans, Victor; Lip, Gregory Y H
Authors
Leo H Bonati
Richard Bulbulia
Alison Halliday
Birgit Bock
Laura Capoccia
Hans-Henning Eckstein
Iris Q Grunwald
Peck Lin Lip
Andre Monteiro
Kosmas I Paraskevas
Anna Podlasek
Barbara Rantner
Kenneth Rosenfield
Adnan H Siddiqui
Henrik Sillesen
Isabelle Van Herzeele
Tomasz J Guzik
Lucia Mazzolai
Victor Aboyans
Gregory Y H Lip
Abstract
Carotid atherosclerotic disease continues to be an important cause of stroke, often disabling or fatal. Such strokes could be largely prevented through optimal medical therapy and carotid revascularization. Advancements in discovery research and imaging along with evidence from recent pharmacology and interventional clinical trials and registries and the progress in acute stroke management have markedly expanded knowledge base for clinical decisions in carotid stenosis. Nevertheless, there is variability in carotid-related stroke prevention and management strategies across medical specialities. Optimal patient care can be achieved by (1) establishing a unified knowledge foundation and (2) fostering multi-specialty collaborative guidelines. The emergent Neuro-Vascular Team concept, mirroring the multi-disciplinary Heart Team, embraces diverse specializations, tailores personalized, stratified medicine approaches to individual patient needs, and integrates innovative imaging and risk-assessment biomarkers. Proposed approach integrates collaboration of multiple specialists central to carotid artery stenosis management such as neurology, stroke medicine, cardiology, angiology, ophthalmology, vascular surgery, endovascular interventions, neuroradiology and neurosurgery. Moreover, patient education regarding current treatment options, their risks and advantages, is pivotal, promting patient's active role in clinical care decisions. This enables optimization of interventions ranging from lifestyle modification, carotid revascularization by stenting or endarterectomy, as well as pharmacological management encompassing statins, novel lipid-lowering and antithrombotic strategies and targeting inflammation and vascular dysfunction. This consensus document provides a harmonized multi-specialty approach to multimorbidity prevention in carotid stenosis patients, based on comprehensive knowledge review, pinpointing research gaps in an evidence-based medicine approach. It aims to be a foundational tool for interdisciplinary collaboration and prioritized patient-centric decision-making. [Abstract copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.]
Citation
Musialek, P., Bonati, L. H., Bulbulia, R., Halliday, A., Bock, B., Capoccia, L., …Lip, G. Y. H. (2023). Stroke risk management in carotid atherosclerotic disease: A Clinical Consensus Statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases. Cardiovascular Research, Article cvad135. https://doi.org/10.1093/cvr/cvad135
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 23, 2023 |
Online Publication Date | Aug 25, 2023 |
Publication Date | Aug 25, 2023 |
Deposit Date | Dec 24, 2023 |
Journal | Cardiovascular Research |
Print ISSN | 0008-6363 |
Electronic ISSN | 1755-3245 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Article Number | cvad135 |
DOI | https://doi.org/10.1093/cvr/cvad135 |
Keywords | Physiology (medical); Cardiology and Cardiovascular Medicine; Physiology |
Public URL | https://nottingham-repository.worktribe.com/output/25344941 |
Publisher URL | https://academic.oup.com/cardiovascres/advance-article/doi/10.1093/cvr/cvad135/7250075 |
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