Carotid artery stenosis screening
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Carotid artery stenosis Microchapters |
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Diagnosis |
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Treatment |
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ACC/AHA Guideline Recommendations |
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Periprocedural Management of Patients Undergoing Carotid Endarterectomy |
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Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease |
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Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
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Case Studies |
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Carotid artery stenosis screening On the Web |
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American Roentgen Ray Society Images of Carotid artery stenosis screening |
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Risk calculators and risk factors for Carotid artery stenosis screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]
Overview
The U.S. Preventive Services Task Force (USPSTF) advises against screening in the general population for asymptomatic carotid artery stenosis (Grade D).[1] In fact, the evidence in the literature is weak regarding the benefits of treatment of asymptomatic carotid artery stenosis.[2] Screening for carotid disease might be considered before cardiac surgery.[3]
2011 American Heart Association/American Stroke Association Guidelines for the Primary Prevention of Stroke[4]
| Class III (No Benefit) |
| "1. Population screening for asymptomatic carotid artery stenosis is not recommended (Class III; Level of Evidence B). (Level of Evidence: B) " |
2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)[3]
Carotid Artery Evaluation and Revascularization Before Cardiac Surgery (DO NOT EDIT)[3]
| Class IIa |
| "1. Carotid duplex ultrasound screening is reasonable before elective coronary artery bypass graft (CABG) surgery in patients older than 65 years of age and in those with left main coronary stenosis, PAD, a history of cigarette smoking, a history of stroke or TIA, or carotid bruit. (Level of Evidence: C)" |
| "2. Carotid revascularization by CEA or CAS with embolic protection before or concurrent with myocardial revascularization surgery is reasonable in patients with greater than 80% carotid stenosis who have experienced ipsilateral retinal or hemispheric cerebral ischemic symptoms within 6 months. (Level of Evidence: C)" |
| Class IIb |
| "1. In patients with asymptomatic carotid stenosis, even if severe, the safety and efficacy of carotid revascularization before or concurrent with myocardial revascularization are not well established. (Level of Evidence: C)" |
References
- ↑ Screening for Asymptomatic Carotid Artery Stenosis. U.S. Preventive Services Task Force Recommendation Statement. 2014 [1]
- ↑ Daniel E. Jonas, Cynthia Feltner, Halle R. Amick,Stacey Sheridan, et al. Screening for Asymptomatic Carotid Artery Stenosis: A Systematic Review and Meta-analysis for the U.S. Preventive Services Task Force. Annals of internal medicine. July 2014.
- ↑ 3.0 3.1 3.2 Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL; et al. (2011). "2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery". Circulation. 124 (4): 489–532. doi:10.1161/CIR.0b013e31820d8d78. PMID 21282505.
- ↑ Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S; et al. (2011). "Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association". Stroke. 42 (2): 517–84. doi:10.1161/STR.0b013e3181fcb238. PMID 21127304.