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Carotid Stenosis

Evangelos Giakoumatos, MD, MSc and Naureen Bashir Rafiq, MD Reviewed 06/2020
 


BASICS

Carotid stenosis may be caused by atherosclerosis, intimal fibroplasia, vasculitis, adventitial cysts, or vascular tumors; atherosclerosis is the most common etiology. 

DESCRIPTION

  • Narrowing of t...

DIAGNOSIS

Screening for carotid stenosis is not recommended. However, in the setting of symptoms suggestive of stroke or TIA, workup for this condition may be indicated. 

HISTORY

  • Identification of modif...

TREATMENT

Smoking cessation, BP control, antiplatelet medication, and statin medication are the primary treatments for both asymptomatic and symptomatic carotid stenosis. 

GENERAL MEASURES

  • Lifestyle mod...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Duplex at 2 to 6 weeks postoperatively

  • Duplex every 6 to 12 months

  • Reoperative CEA or CAS is reasonable, if there is rapidly progressive restenosi...

REFERENCES

1
Meschia JF, Bushnell C, Boden-Albala Bet al; and American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Functio...

ADDITIONAL READING

  • Go C, Avgerinos ED, Chaer RAet al. Long-term clinical outcomes and cardiovascular events after carotid endarterectomy. Ann Vasc Surg.  2015;29(6):1265–1271. [View Abstract on O...

CODES

ICD10

  • I65.29 Occlusion and stenosis of unspecified carotid artery

  • I65.21 Occlusion and stenosis of right carotid artery

  • I65.22 Occlusion and stenosis of left carotid artery

  • I65.23 Occlusion and sten...

CLINICAL PEARLS

  • Atherosclerosis is responsible for 90% of all cases of carotid artery stenosis.

  • Duplex US is the best initial imaging modality.

  • Antiplatelet therapy and aggressive treatment of vascular ...

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