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The role of the carotid database in prospective survey of patients with carotid atherosclerosis unsuitable for surgical or endovascular treatment

Randomized Controlled Trials (RCT) comparing carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS) provide the key data in appropriate treatment of carotid atherosclerosis. Still further survey of patients' not meeting inclusion criteria or patients' unsuitable for randomization is not mentioned during the follow up and thus seriously impairing the message these trials are sending to the world medical community. The answer to this question can be obtained from specially created carotid databases (CDB) that include all patients diagnosed and treated for carotid atherosclerosis. Besides preoperative characteristics, CDB includes all the details regarding diagnostic (ultrasound, CT angiography) and interventional (CEA or CAS) procedures in each included patient. In addition to this valuable material, CDB provides very important information about the patients during the follow-up and especially the patients who were not treated by any interventional procedure (CEA or CAS). The results of further treatment and follow up of patients' unsuitable for the CEA or CAS are needed to give 'real-world' answer which of the two procedures is superior to another in the treatment of carotid atherosclerosis. Specially created carotid databases could give the answers to this specific question.