Avanços no tratamento de estenose carotídea: uma revisão bibliográfica

Abstract

Carotid stenosis involves the narrowing of a crucial blood vessel responsible for transporting blood to the brain, often associated with atherosclerosis. Severely stenosed carotid arteries are considered decisive factors for cerebrovascular events. The decision regarding the indication for invasive treatment of carotid artery stenosis requires careful attention to the percentage of stenosis caused by atherosclerotic plaque and the presence of neurological symptoms suggestive of ischemia. The choice between carotid endarterectomy (CEA) and carotid artery stent placement (CAS), along with other approaches to carotid stenosis, remains a widely debated topic today. Objective: To analyze the main innovations in treatment strategies for symptomatic therosclerotic carotid stenosis, as highlighted in recent literature studies. Methodology: Integrative review conducted by searching the PubMed and Scielo databases from 2020 to 2023. Results: A total of 19,213 articles were identified, and 477 articles met the eligibility criteria. Subsequently, based on the review of titles, abstracts, and full texts, 27 studies were used as necessary theoretical foundation for the researched topic. Conclusion: This study identified advances in preferred approaches for managing symptomatic carotid stenoses, comparing techniques and their advancements. The approach to carotid stenosis still lacks consensus in scientific literature, making this study highly relevant by highlighting the main updates in this area. Furthermore, the need for subsequent research to contribute to the development of effective protocols that unify the approach to carotid stenosis is emphasized, relying on the latest information in the scientific field to achieve enhanced therapeutic outcomes in the treatment of this pathology.