carotid disease Flashcards
how does carotid artery disease cause strokes
embolic
what makes a carotid plaque high risk
symptomatic ones!
how do you treat a carotid artery plaque?
you operate
if a stroke is ischemic what can it be due to
embolism - carotid or A fib
Thrombotic
most of the time an embolus will endup where in the brain?
MCA
you do not talk about claudication in the brain!!
Not a low flow problem
TIAs are
NOT claudication they are infarcts!!!!
- claudication happens in muscles
Carotid strokes are
EMBOLIC
carotid plaques are either
symptomatic or asymptomatic
Symptomatic stroke
high likelihood of causing another stroke
weakness or numbness in contralateral leg or arm or leg and arm or amaurosis fugax - ipsilateral
Symptomatic carotid stenosis
- carotid
conventional angio has a risk of
stroke 1%
CTA vs MRA
MR details of brain, CTA limited brain info
medical MX of stroke due to carotid disease
- statin
- anti platelet
stroke rate in stenting vs endarcterectomy
- 10% vs 3-5%
TX for Symptomatic carotid a. stenosis
NOT controversial
Amarosis Fugax happens
ipsilateral to stenosis
Need to have how much stenosis for treatment
operate over 50%
less than 50% medical mx
For asymptomatic carotid stenosis need
60% stenosis before treatment
if artery is completely occluded
do not operate they can embolize
subclavial steal syndrome can happen in
R in a R handed patient
