Carotid artery stenosis

Question 1

What is carotid artery stenosis and how are they picked up?

Answer 1

• Narrowing of the lumen of carotid artery
• Only picked up when small % of plaques rupture and embolise to cause either a:
  
  • TIA
  • stroke
  • amarousos fugax

Question 2

What is the investigation of choice for carotid artery stenosis?

Answer 2

• Carotid duplex → identify >70% stenosis; elevated blood flow veolicites along with visualisation of details of the plaque within carotid arteries

Question 3

What is the management for symptomatic carotid artery stenosis (eg. stroke, TIA)?

Answer 3

• If >65-70% stenosis → endarterectomy as reduces further strokes
• Antiplatelets → aspirin or clopidogrel

Question 4

What is the management of asymptomatic carotid stenosis <70%?

Answer 4

• Antiplatelet therapy → aspirin
• Cardiovascular risk reduction

Question 5

What is the management of asymptomatic carotid stenosis > 70%?

Answer 5

• Antiplatelet therapy + cardio risk reduction
• Adjunct of carotid endarterectomy