Carotid artery stenosis: Difference between revisions

	Carotid artery stenosis Microchapters
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Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Carotid artery stenosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Testing Guidelines
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
CT
MRI
MRA
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
ACC/AHA Guideline Recommendations
Diagnostic Testing Guidelines Recommendation
Primary Prevention and Screening Guidelines Recommendations
Secondary Prevention Guidelines Recommendations
Selection of Patients for Carotid Revascularization
Periprocedural Management of Patients Undergoing Carotid Endarterectomy
Management of Patients Undergoing Carotid Artery Stenting
Restenosis After Carotid Endarterectomy or Stenting
Vascular Imaging in Patients With Vertebral Artery Disease
Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease
Occlusive Disease of the Subclavian and Brachiocephalic Arteries
Fibromuscular Dysplasia
Cervical Artery Dissection
Case Studies
Case #1
Carotid artery stenosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Carotid artery stenosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Carotid artery stenosis
CDC on Carotid artery stenosis
Carotid artery stenosis in the news
Blogs on Carotid artery stenosis
Directions to Hospitals Treating Carotid artery stenosis
Risk calculators and risk factors for Carotid artery stenosis

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Latest revision as of 19:55, 30 January 2013

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Carotid artery stenosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Related Chapters

nl:Carotisstenose

Template:WikiDoc Sources

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-  DiseasesDB     = 31178 |
-  ICD10          = {{ICD10|I|65|2|i|60}} |
-  ICD9           = {{ICD9|433.1}} |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = |
-  eMedicineSubj  = |
-  eMedicineTopic = |
-  MeshID         = D016893 |
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-{{SI}}
+{{Carotid artery stenosis}}
 {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
-==Overview==
+==[[Carotid artery stenosis overview|Overview]]==
-'''Carotid arterial stenosis''' is a narrowing of the lumen of the [[carotid artery]], usually by [[atheroma]] (a fatty lump or plaque  causing[[ atherosclerosis]]). Atheroma's may cause [[transient ischemic attack]]s (TIAs) and [[cerebrovascular accident]]s (CVAs) as it obstructs the bloodstream to the [[brain]].  It also has the potential to generate [[embolus|emboli]] (blood clots) that obstruct the cerebral arteries.
+==[[Carotid artery stenosis historical perspective|Historical Perspective]]==
-The narrowing can either be [[asymptomatic]] (causing no medical problems) or presents with symptoms such as TIAs and CVAs.
+==[[Carotid artery stenosis classification|Classification]]==
-==Diagnosis==
+==[[Carotid artery stenosis pathophysiology|Pathophysiology]]==
-Carotid stenosis is usually diagnosed by [[ultrasound]] scan of the neck arteries.  This is the first imaging option and usually used for follow up and observation as it involves no radiation and no contrast agents that may cause [[allergic]] reactions.
-If there is doubt whether the narrowing is still patent (open to blood flow) and the patient is to be assessed for treatment, the next imaging option would either be [[computed tomography]] [[angiogram]] (CTA) or a [[magnetic resonance imaging]] angiogram (MRA).
+==[[Carotid artery stenosis causes|Causes]]==
-CTA is usually used as it's more widely available and faster (takes only several minutes).  However, it does involve significant [[X-ray]] radiation and the use of [[contrast agent]]s which is usually iodinated, which can cause allergic reactions, even [[anaphylaxis]] and can also cause [[renal failure]].
+==[[Carotid artery stenosis differential diagnosis|Differentiating Carotid artery stenosis from other Diseases]]==
-MRA takes much longer to complete, more costly and not yet as widely available.
+==[[Carotid artery stenosis epidemiology and demographics|Epidemiology and Demographics]]==
-==Ultrasound Criteria for Carotid Artery Stenosis==
+==[[Carotid artery stenosis risk factors|Risk Factors]]==
-*Normal:
-**ICA PSV is less than 125 cm/sec and no plaque or intimal thickening is visible sonographically.
-**Additional criteria include ICA/CCA PSV ratio < 2.0 and ICA EDV < 40 cm/sec.
-*<50% ICA stenosis:
-**ICA PSV is less than 125 cm/sec and plaque or intimal thickening is visible sonographically.
-**Additional criteria include ICA/CCA PSV ratio < 2.0 and ICA EDV < 40 cm/sec.
-*50%–69% ICA stenosis:
-**ICA PSV is 125–230 cm/sec and plaque is visible sonographically.
-**Additional criteria include ICA/CCA PSV ratio of 2.0–4.0 and ICA EDV of 40–100 cm/sec.
-*>=70% ICA stenosis but less than near occlusion
-**ICA PSV is greater than 230 cm/sec and visible plaque and luminal narrowing are seen at gray-scale and color Doppler US (The higher the Doppler parameter lies above the threshold of 230 cm/sec, the greater the likelihood of severe disease).
-**Additional criteria include ICA/CCA PSV ratio > 4 and ICA EDV > 100 cm/sec.
-*Vear occlusion of the ICA:
-**Velocity parameters may not apply, since velocities may be high, low, or undetectable.
-**Diagnosis is established primarily by demonstrating a markedly narrowed lumen at color or power Doppler US (35).
-*Total occlusion of the ICA
-**No detectable patent lumen at gray-scale US and no flow with spectral, power, and color Doppler US. <ref>Edward G. Grant, Carol B. Benson, Gregory L. Moneta, Andrei V. Alexandrov, J. Dennis Baker, Edward I. Bluth, Barbara A. Carroll, Michael Eliasziw, John Gocke, Barbara S. Hertzberg, Sandra Katanick, Laurence Needleman, John Pellerito, Joseph F. Polak, Kenneth S. Rholl, Douglas L. Wooster, and Eugene Zierler. [http://radiology.rsnajnls.org/cgi/content/short/2292030516v1 Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis—Society of Radiologists in Ultrasound Consensus Conference.] Radiology published online September 18, 2003.</ref>
-==Cardiac MRI==
-==ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance<ref name="pmid20479157">{{cite journal| author=American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA et al.| title=ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. | journal=Circulation | year= 2010 | volume= 121 | issue= 22 | pages= 2462-508 | pmid=20479157 | doi=10.1161/CIR.0b013e3181d44a8f | pmc=PMC3034132 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20479157  }} </ref> (DO NOT EDIT)==
-{{cquote|
-CMR may be used for defining the location and extent of carotid arterial stenoses.
-}}
-==Treatment==
+==[[Carotid artery stenosis screening|Screening]]==
-Options for treatment include:
-*Conservative: [[Antiplatelet drug]]
-*[[Carotid endarterectomy]] (surgical removal of the atheroma)
-*[[Carotid stenting]]
-==Examples==
+==[[Carotid artery stenosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-<div align="left">
+==Diagnosis==
-<gallery heights="175" widths="175">
+[[Carotid artery stenosis diagnostic testing guidelines|Diagnostic Testing Guidelines]] | [[Carotid artery stenosis history and symptoms|History and Symptoms]] | [[Carotid artery stenosis physical examination|Physical Examination]] | [[Carotid artery stenosis laboratory findings|Laboratory Findings]] | [[Carotid artery stenosis electrocardiogram|Electrocardiogram]] | [[Carotid artery stenosis CT|CT]] | [[Carotid artery stenosis MRI|MRI]] | [[Carotid artery stenosis MRA|MRA]] | [[Carotid artery stenosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Carotid artery stenosis other imaging findings|Other Imaging Findings]] | [[Carotid artery stenosis other diagnostic studies|Other Diagnostic Studies]]
-Image:Carotid-artery-stenosis-001.jpg
-Image:Carotid-artery-stenosis-002.jpg
-Image:Carotid-artery-stenosis-003.jpg
-</gallery>
-</div>
+==Treatment==
-{{#ev:youtube|nkCmbY_oLAo}}
+[[Carotid artery stenosis medical therapy|Medical Therapy]] | [[Carotid artery stenosis surgery|Surgery]] | [[Carotid artery stenosis primary prevention|Primary Prevention]] | [[Carotid artery stenosis secondary prevention|Secondary Prevention]] | [[Carotid artery stenosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Carotid artery stenosis future or investigational therapies|Future or Investigational Therapies]]
+==Case Studies==
+[[Carotid artery stenosis case study one|Case #1]]
-==See also==
+==Related Chapters==
 *[[Ocular ischemic syndrome]]
+*[[External carotid artery]]
-==References==
+*[[Common carotid artery]]
-{{Reflist|2}}
+*[[Internal carotid artery]]
+*[[Carotid artery dissection]]
+*[[Amaurosis fugax]]
 {{Circulatory system pathology}}
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 [[Category:Emergency medicine]]
 [[Category:Overview complete]]
+[[Category:Disease]]
 [[nl:Carotisstenose]]

Carotid artery stenosis: Difference between revisions

Latest revision as of 19:55, 30 January 2013

Diagnosis

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