carotid stenosis

Question 1

symptomatic carotid artery disease management outline?

Answer 1

if <70% stenosis, medical treatment with antiplatelets, statins, control risk factors

if >70% stenosis, intervene with carotid endarterectomy or angioplasty with stent

Question 2

which cases is it a must to intervene in asymptomatic patients?

Answer 2

-severe bilateral stenosis >80%
-ruptured plaque more than 40mm independant of stenosis degree
-complete occlusion of ICA on one side, and >70% stenosis in the other
-pt with >80% stenosis undergoing major vascular surgery

Question 3

what is the management for patients it 100% occlusion?

Answer 3

no intervention because it leads to embolization. only medical tx

Question 4

how to know ICA vs ECA?

Answer 4

-look at the branch for superior thyroid ->ECA
-Look at the waveforms. ICA -> low resistance. ECA -> high resistance