Carotid Artery Stenosis

Question 1

Definition and features of carotid artery stenosis

Answer 1

• Stenosis of the carotid arteries secondary to athersclerosis
• Presentation
  
  • Asymptomatic
  • Syncope
  • TIAs
  • Cognitive impairment
  • Carotid bruit

Question 2

Diagnosis and management of carotid artery stenosis

Answer 2

• Diagnosis by carotid US or angiogram (CT or MRI)
• Treat modifiable risk factors
• Grading
  
  • Minor – 0 to 49% narrowed
  • Moderate – 50 to 69% narrowed
  • Severe – 70 to 99% blocked
• When to operate?
  
  • Patients who have had a stroke or TIA and have a moderate or severe stenosis should have a carotid endarterectomy (NICE)
• Surgery
  
  • Endarterectomy
  • Angioplasty and stenting