Improper management of carotid artery disease for stroke prevention is prevalent. Accumulating misconceptions (‘furphies’) drive the overuse of carotid artery procedures and the inappropriate use of medicines. Recognition of these furphies is essential to improve disease management and optimize patient outcomes.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Abbott, A. L. et al. Misconceptions regarding the adequacy of best medical intervention alone for asymptomatic carotid stenosis. J. Vasc. Surg. 71, 257–269 (2020).
Naylor, A. R. et al. Editor’s choice — management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur. J. Vasc. Endovasc. Surg. 55, 3–81 (2018).
Abbott, A. L. et al. Systematic review of guidelines for the management of asymptomatic and symptomatic carotid stenosis. Stroke 46, 3288–3301 (2015).
Batchelder, A. J. et al. Overview of primary and secondary analyses from 20 randomised controlled trials comparing carotid artery stenting with carotid endarterectomy. Eur. J. Vasc. Endovasc. Surg. 58, 479–493 (2019).
Brott, T. G. et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N. Engl. J. Med. 363, 11–23 (2010).
Halliday, A. et al. 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1): a multicentre randomised trial. Lancet 376, 1074–1084 (2010).
Bonati, L. H. et al. Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial. Lancet 385, 529–538 (2015).
McNeil, J. J. et al. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N. Engl. J. Med. 379, 1509–1518 (2018).
Anand, S. S. et al. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet 391, 219–229 (2018).
Ganesan, A. N. et al. The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: a systematic review and meta-analysis. Eur. Heart J. 37, 1591–1602 (2016).
Acknowledgements
A.L.A. is a neurologist who has received grants for independent research into stroke prevention from the National Health and Medical Research Council of Australia and the BUPA Health Foundation. A.L.A. is the founding member of the Faculty Advocating Collaborative and Thoughtful Carotid Artery Treatments (FACTCATS; see FACTCATS.org).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The author declares no competing interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Abbott, A.L. Carotid stenosis management: time to address the misconceptions (‘furphies’). Nat Rev Cardiol 18, 383–384 (2021). https://doi.org/10.1038/s41569-021-00543-2
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41569-021-00543-2