What are the recommendations for extracranial carotid stenosis?
The recommendations for extracranial carotid stenosis are to study new therapies in well-designed clinical trials, including novel antithrombotic regimens (eg, direct thrombin inhibitors), improved endovascular treatments (eg, submaximal balloon angioplasty), indirect bypass, and ischemic preconditioning. Determining the interaction between hemodynamic function or collateral flow and treatments (eg, BP management and endovascular therapy) is also recommended. Additionally, developing and using surrogate markers of stroke risk (eg, plaque characteristics) or high-risk prognostic features (eg, diabetes) that may lead to new therapies or improve patient selection for future therapeutic trials is suggested. Lastly, investigating genetic variants that relate to ICAS (eg, ring finger protein 213) and whether such variants affect the rate of stroke recurrence or treatment responses is recommended. 