Prevention

Local versus general anaesthesia for carotid endarterectomy

Abstract Background Carotid endarterectomy may significantly reduce the risk of stroke in people with recently symptomatic, severe carotid artery stenosis. However, there are significant perioperative risks that may be minimised by performing the operation under local rather than general anaesthetics. This is an update of a Cochrane Review first published in 1996, and previously updated […]

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Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases

Abstract Background Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention. Objectives To determine the effectiveness […]

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Patches of different types for carotid patch angioplasty

Abstract Background Extracranial carotid artery stenosis is the major cause of stroke, which can lead to disability and mortality. Carotid endarterectomy (CEA) with carotid patch angioplasty is the most popular technique for reducing the risk of stroke. Patch material may be made from an autologous vein, bovine pericardium, or synthetic material including polytetrafluoroethylene (PTFE), Dacron, […]

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Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome

Abstract Background Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial or venous thrombosis (or both), and/or pregnancy morbidity in association with the presence of antiphospholipid antibodies. The prevalence of APS is estimated at 40 to 50 cases per 100,000 people. The most common sites of thrombosis are cerebral arteries and deep veins […]

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Carotid endarterectomy for symptomatic carotid stenosis

Abstract Background Stroke is the third leading cause of death and the most common cause of long‐term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of a Cochrane […]

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Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack

Abstract Background Stroke is a leading cause of morbidity and mortality worldwide. Antiplatelet agents are considered to be the cornerstone for secondary prevention of stroke, but the role of using multiple antiplatelet agents early after stroke or transient ischaemic attack (TIA) to improve outcomes has not been established. Objectives To determine the effectiveness and safety […]

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Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis

Abstract Background Intracranial atherosclerotic stenosis (ICAS) is an arterial narrowing in the brain that can cause stroke. Endovascular therapy and medical management may be used to prevent recurrent ischaemic stroke caused by ICAS. However, there is no consensus on the best treatment for people with ICAS. Objectives To compare the safety and efficacy of endovascular […]

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Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack

Abstract Plain language summary Anti‐inflammatory medications for preventing major heart events and strokes following ischaemic stroke (stroke due to a clot) or mini‐stroke Review question Do anti‐inflammatory medications have a role in preventing future serious heart conditions or stroke in people who have previously had a stroke or a transient ischaemic attack (TIA, or ‘mini‐stroke’) as the result of […]

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Carotid artery stenting versus endarterectomy for treatment of carotid artery stenosis

Abstract Background Carotid artery stenting is an alternative to carotid endarterectomy for the treatment of atherosclerotic carotid artery stenosis. This review updates a previous version first published in 1997 and subsequently updated in 2004, 2007, and 2012. Objectives To assess the benefits and risks of stenting compared with endarterectomy in people with symptomatic or asymptomatic […]

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Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in patients with stroke or transient ischaemic attack

Abstract Background Peroxisome proliferator‐activated receptor gamma (PPAR‐γ) agonists are insulin‐sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review first published in January 2014 and subsequently updated […]

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