Carotid stenosis Flashcards
1
Q
Overview of management
A
Medical management: hypertension, lipids**, smoking cessation
If 100% occlusion it is the ACA that is keeping you alive
Carotid endart:
- pre op aspirin yes
- DAPT 3 months post yes
Dissection:
-3 months hep/warf
Symptomatic TIA/stroke:
- less than 50% sten no benefit
- 50-69% benefit
- 70-99% most benefit
- most benefit if op within 2 weeks
Asymptomatic
- trial stopped early because of high perioperative risk
- 1% ARR per year so only to be considered in long life expectancy
- NO evidence for women (no benefit shown)
2
Q
Stenting?
A
under 70 stenting may be better
over 70 endart may be better
may be higher stroke, MI, death in stent
au guidelines i think say no
