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General Medicine

Carotid Stenosis

Evangelos Giakoumatos, MSc, MD and Naureen Bashir Rafiq, MD Reviewed 06/2022
 


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 m...

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  B, et al; and American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Ca...

ADDITIONAL READING

  • Go  C, Avgerinos  ED, Chaer  RA, et al. Long-term clinical outcomes and cardiovascular events after carotid endarterectomy. Ann Vasc Surg.  2015;29(6...

SEE ALSO

Algorithms: Stroke; Transient Ischemic Attack and Transient Neurologic Defects 

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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Related Images
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<bold>FIGURE 10-23. Xanthomas in familial hypercholesterolemia.</bold><bold>A.</bold> Dorsum of hand. <bold>B.</bold> Arcus lipoides represents the deposition of lipids in the peripheral cornea. <bold>C.</bold> Extensor surface of elbow. <bold>D.</bold> Knees

 

<bold>FIGURE 10-23. Xanthomas in familial hypercholesterolemia.</bold><bold>A.</bold> Dorsum of hand. <bold>...

Xanthomas in familial hypercholesterolemia. Arcus lipoides represents the deposition of lipids in the peripheral cornea.

 

Xanthomas in familial hypercholesterolemia. Arcus lipoides represents the deposition of lipids in the peripheral cornea.

 
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