Carotid Artery Stenosis

Question 1

What is carotid artery stenosis?

Answer 1

Narrowing of carotid arteries due to build up of atherosclerotic plaque
Most commonly internal CA

Question 2

Risk factors of carotid artery stenosis

Answer 2

• > 65
• smoking
• hypertension
• diabetes mellitus
• obesity
• history of CVD or family history
• Hyperlipidaemia

Question 3

Classification of carotid artery stenosis

Answer 3

Due to the degree of stenosis depending of diameter reduction:
- mild: 50%
- moderate: 50-69%
- severe: 70-99%

Question 4

Presentation fo carotid artery stenosis

Answer 4

• asymptomatic
• often diagnosed after TIA or stroke
• carotid bruit on auscultation

Question 5

Diagnosis of carotid artery stenosis

Answer 5

• carotid USS first line imaging for
• CT or MRI angiogram before surgery

Question 6

Management of carotid artery stenosis

Answer 6

• healthy diet + exercise
• smoking cessation
• statins
• antiplatelets
• manage co-morbidities
• carotid endarterectomy
• angioplasty + stenting

Question 7

What does endarterectomy involve?

Answer 7

• incision in neck
• opening carotid artery + scraping out plaque

Question 8

What can be damaged during endarterectomy?
What symptoms can that cause?

Answer 8

• facial nerve - lower lip drooping
• glossopharyngeal nerve - swallowing difficulties
• recurrent laryngeal nerve: hoarse voice
• Hypoglossal nerve: unilateral tongue paralysis