%0 Journal Article
%T Manejo actual de la estenosis de car¨®tida: Tratamiento endovascular comparado con endarterectom¨ªa Current management of carotid stenosis: Endovascular treatment versus endarterectomy
%A Elvira Jim¨¦nez G
%A Rafael Oteros F
%A Fernando Delgado A
%A Antonio Cano S
%J Revista Chilena de Radiolog¨ªa
%D 2012
%I Publimpacto
%X En estenosis carotidea, la ¨²nica manera de prevenir nuevos eventos cerebrovasculares era mediante antiagregaci¨®n. Despu¨¦s de los estudios NASCET y ECST se estableci¨® que la endarterectom¨ªa consegu¨ªa mejores resultados. Ahora se ha establecido la terapia endovascular como alternativa. Nuestro objetivo es mostrar la evoluci¨®n de la terapia endovascular en estenosis carotidea, contrastar los resultados entre tratamiento endovascular, m¨¦dico y quir¨²rgico y exponer la situaci¨®n actual de la terapia endovascular. Algunos estudios se realizaron hace d¨¦cadas y tanto la t¨¦cnica endovascular como los tratamientos m¨¦dicos, no son comparables con los de hoy. Varios estudios coinciden en que el stenting beneficia a menores de 70 a os y presenta al menos iguales resultados que la endarterectom¨ªa a corto plazo, con mayor tasa de reestenosis a largo plazo. Quedan por resolver la indicaci¨®n de tratamiento en pacientes asintom¨¢ticos o la utilizaci¨®n de sistemas de protecci¨®n. El tratamiento debe ser individualizado en un equipo multidisciplinar. Antiplatelet therapy used to be the only way to prevent further cerebrovascular events in patients with carotid stenosis. After publication of final results of the European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET), endarterectomy was considered the best treatment option. Currently, endovascular treatment of atherosclerotic carotid artery stenosis has been established as an alternative to surgical endarterectomy. Our aim is to show the evolution of endovascular therapy in carotid stenosis, to compare outcomes between endovascular, medical and surgical treatments, and to analize the current state of endovascular therapy. It is worth underscoring that many of the studies were conducted decades ago and consequently both the endovascular technique and medical treatments used then greatly differ from current practices. Several studies agree stenting benefits patients under 70 years of age and exhibits, at least, same short-term results as endarterectomy, along with higher rate of long-term restenosis. Indication for treatment in asymptomatic patients and the use of protection systems remain an unresolved issue. A multidisciplinary team should implement an individualized treatment plan for each patient.
%K Angioplast¨ªa
%K Endarterectomia
%K Estenosis carotidea
%K Ictus carotideo
%K Angioplasty
%K Endarterectomy
%K Carotid stenosis
%K Stroke
%U http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-93082012000200003