Carotid Disease Flashcards
MC preventable cause of ischemic stroke
atherosclerosis of the extracranial carotid arteries
How is most carotid artery disease identified
bruit in the neck
What is the risk of stroke in a patient who has experienced a TIA
25% in the first year
When do most strokes occur after a TIA
weeks to months after
What is the diagnostic modality of choice to dx carotid disease
Carotid duplex
What is a CT or MRI used for in carotid disease
assess for cerebral infarction
When is a carotid endarterectomy indicated
symptomatic disease (TIA or stroke), greater than 50% internal carotid stenosis), asx greater than 60% stenosis
Do you operate on patients with totally occluded carotid ds
no
What nerve lies in the carotid sheath
vagus
Where is the vagus nerve located
between the jugular vein and carotid artery
What nerve lies near the carotid bifurcation
hypoglossal nerve
What artery lies near the carotid bifurcation
superior thyroid artery
How should an arteriotomy during a CEA be closed
with a patch
What is an eversion endarterectomy
the common and or external carotid arteries is removed, and the ICA is reanastomosed to the common carotid artery
How long is blood pressure instability seen post op
usually 4-8 hours
What is the treatment for post-op bleeding
reexploration
Are wound infections common or uncommon after CEA
uncommon
What is the most frequent complication after a CEA
cranial nerve injury
What causes restenosis within the first 36 months
intimal hyperplasia
What cells are seen in intimal hyperplasia
fibroblasts
Name the 6 nerves commonly injured during CEA
hypoglossal, recurrent larygngeal, superior laryngeal, marginal mandibular, glossopharyngeal, spinal accessory
What is the treatment for high risk patients with carotid disease
carotid stenting
What is restenosis after 36months attributed to
progression of atherosclerotic disease
What surveillance is done post-op
duplex US
