SURGICAL TREATMENT OF CAROTID STENOSIS: A COMPARATIVE ANALYSIS (Atena Editora)

Abstract

Carotid stenosis is a reduction in diameter of the main arteries that carry blood to the brain. One of the risk factors for this narrowing is atherosclerosis, which is an inflammatory pathology, where an atheromatous plaque reduces blood flow. This blockage can be complete or partial, and there may be complications depending on the location of this obstruction, which may result in a stroke. The indication for surgical treatment must be assessed on an individual basis. Angioplasty is one of the most recent treatments and indicated for symptomatic patients. In asymptomatic patients, it is not as effective as endarterectomy, but in larger stenoses, endarterectomy has a greater benefit in preventing ischemic stroke, not demonstrating as much effectiveness and with contraindication in stenoses less than 30%. The objective is to carry out an analysis of the treatments for carotid stenosis, comparing the surgical procedures of endarterectomy and angioplasty, identifying favorable and unfavorable aspects that each treatment can favor. This is an integrative bibliographic review of the literature and the following databases were used to carry out this study: Scielo, Lilacs and Medline. Initially, 13 articles were identified and after the inclusion and exclusion criteria, 8 studies were selected for analysis. It was noted in the discussion of this work that there is evidence in a group of the same patients treated by the same surgeon. In this case, both endarterectomy and angioplasty, the two techniques studied, presented the main comorbidities associated with arterial hypertension, diabetes mellitus, coronary disease and dyslipidemia. In both endarterectomy and angioplasty, this evidence is important to reflect on these risks and evidence.