Response to “Re: Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)”

Abstract

We thank Professor Liapis for taking the time to respond to the recently published 2017 ESVS Carotid and Vertebral artery guidelines.1Naylor A.R. Ricco J.-B. de Borst G.J. Debus S. de Haro J. Halliday A. et al.Management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS).Eur J Vasc Endovasc Surg. 2018; 55: 3-81Abstract Full Text Full Text PDF PubMed Scopus (673) Google Scholar We appreciate his positive comments regarding the style and content of the guideline and its recommendations. As Professor Liapis will understand (as chairman of the 2009 ESVS Carotid Guidelines2Liapis C.D. Bell P.R.F. Mikhailidis D. Sivenius J. Nicolaides A.N. Fernandes e Fernandes J. et al.ESVS Guidelines. Invasive treatment for carotid stenosis: indications, techniques.Eur J Vasc Endovasc Surg. 2009; 37: S1-S19Abstract Full Text Full Text PDF PubMed Scopus (519) Google Scholar), the 2017 writing group had to adhere to guidance regarding the overall word count. Shortly after deciding on the titles of the various carotid chapters, we were then asked to include the investigation and management of atherosclerotic vertebral artery disease, thereby significantly increasing the overall burden of the project. As was stated in the introduction to the guidelines, the writing group did not include non-atherosclerotic conditions that affect the carotid and vertebral arteries, not least because of the very extensive number of conditions that would have had to be included (fibromuscular dysplasia, carotid body tumours, paragangliomas, acute dissection, radiation arteritis, giant cell arteritis, Takayasu's arteritis, carotid aneurysms, and trauma, etc.). This was partly because of the constraints applied (regarding word count), but mainly because many non-atherosclerotic conditions also affect other vascular territories within the body, and it was felt that these would be best considered as a separate guideline. This suggestion has already been passed to the ESVS Guidelines Committee for future consideration. The co-chairmen do, however, apologise for not referencing the 2009 ESVS guidelines on carotid disease2Liapis C.D. Bell P.R.F. Mikhailidis D. Sivenius J. Nicolaides A.N. Fernandes e Fernandes J. et al.ESVS Guidelines. Invasive treatment for carotid stenosis: indications, techniques.Eur J Vasc Endovasc Surg. 2009; 37: S1-S19Abstract Full Text Full Text PDF PubMed Scopus (519) Google Scholar within the introduction to the 2017 guidelines. This was an oversight and we would like to place on record how influential the 2009 carotid guidelines became after their publication. Re: “Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)”European Journal of Vascular and Endovascular SurgeryVol. 55Issue 6PreviewThe European Society for Vascular Surgery (ESVS) is to be commended for updating1 the “ESVS Guidelines. Invasive Treatment for Carotid Stenosis: Indications, Techniques.”2 Managing patients with cerebral ischaemia is of paramount importance, taking into consideration that despite advances in medical and surgical/interventional therapies, the number of strokes remains high in most parts of the world,3 and the prevalence of vascular risk factors in patients with stroke is increasing.4 Full-Text PDF Open Archive