Carotid Artery Disease Flashcards
1
Q
What is carotid artery stenosis usually secondary to and what is consequence
A
Secondary to atherosclerosis
Risk of embolus breaking away causing embolic stroke
2
Q
CLASSIFICATION
A
- Mild
- <50% reduction in diameter
- Moderate
- 50-69% reduction in diameter
- Severe
- >=70% reduction in diameter
3
Q
CLINICAL FEATURES
Presentation
A
- Usually asymptomatic, being diagnosed after TIA or stroke
- Carotid bruit may be heard
4
Q
INVESTIGATIONS
First choice
A
- Carotid US - diagnose and assess severity
- CT or MRI angiogram - assess in more detail before surgical intervention
5
Q
MANAGEMENT
General principles
A
- Conservative management - addressing risk factors
- Medical therapy
- Surgical intervention
6
Q
MANAGEMENT
Addressing risk factors
A
- Stop smoking
- Healthy diet and exercise
- Optimal management of co-morbidities (eg hypertension and diabetes)
7
Q
MANAGEMENT
Medication
A
- Antiplatelet medication (eg aspirin, clopidogrel and ticagrelor)
- Lipid lowering medication (eg atorvastatin)
8
Q
MANAGEMENT
Surgical options
A
- Carotid endarectomy
- Angioplasty and stenting
9
Q
Possible complications of carotid endarectomy
A
- Stroke
- Damage to nearby nerves
- Facial nerve - facial weakness
- Glossopharyngeal nerve - swallowing difficulties
- Recurrent laryngeal nerve - hoarse voice
- Hypoglossal nerve - unilateral tongue paralysis
