My name is Kosmas Paraskevas.
I am a vascular specialist at
the Department of Vascular Surgery of the Royal Free Hospital in London, UK.
The title of my talk is "How to Identify Which Patients with
Asymptomatic Carotid Stenosis Could Benefit from Endarterectomy or Stenting."
I have no conflicts of interest.
First, some facts.
Stroke is the fifth leading cause of death in the US,
killing about 140,000 Americans each year.
Someone in the United States has a stroke every 40 seconds.
Every four minutes somebody dies of stroke.
Every year about 795,000 people in the United States have a stroke.
About 610,000 of these are first and new strokes while 185,000 are recurrent strokes.
In Europe, stroke causes about 1,100,000 deaths per year.
This makes it the second commonest cause of death.
More than half of all stroke survivors
remain dependent on others for everyday activities.
Stroke cost United States about $34 billion annually,
including the cost of health care services,
medications and lost productivity.
By 2030, stroke is predicted to increase to $300 billion.
About 85% of all strokes are ischemic,
whereas 15% are hemorrhagic.
Thromboemboli originating from ipsilateral carotid stenosis
are the cause of approximately 50% of ischemic strokes.
Only one in five of these patients has had
a warning in the form of a transit ischemic attack.
The other four out of five patients had previously asymptomatic carotid stenosis.