Patients With Cervical Artery Dissection: Difference between revisions
Jump to navigation
Jump to search
Created page with "__NOTOC__ {{Carotid artery stenosis}} {{CMG}} {|class="wikitable" |- | colspan="1" style="text-align:center; background:LightGreen"|ACC AHA guidelines classification scheme..." |
No edit summary |
||
| (2 intermediate revisions by the same user not shown) | |||
| Line 3: | Line 3: | ||
{{CMG}} | {{CMG}} | ||
==Cervical Artery Dissection== | |||
===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)<ref name="pmid21282505">{{cite journal| author=Brott TG, Halperin JL, Abbara S, Bacharach JM, Barr JD, Bush RL et al.| title=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. | journal=Circulation | year= 2011 | volume= 124 | issue= 4 | pages= 489-532 | pmid=21282505 | doi=10.1161/CIR.0b013e31820d8d78 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21282505 }} </ref>=== | |||
====Recommendations for Management of Patients With Cervical Artery Dissection==== | |||
{|class="wikitable" | {|class="wikitable" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''Contrast-enhanced [[CTA]], [[MRA]], and catheter-based contrast angiography are useful for diagnosis of cervical artery dissection. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
| Line 16: | Line 18: | ||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''For patients with symptomatic cervical artery dissection, anticoagulation with intravenous heparin (dose-adjusted to prolong the partial thromboplastin time to 1.5 to 2.0 times the control value) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), low-molecular-weight heparin (in the dose recommended for treatment of venous thromboembolism with the selected agent) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), or oral anticoagulation without antecedent heparin can be beneficial for 3 to 6 months, followed by antiplatelet therapy with aspirin (81 to 325 mg daily) or clopidogrel (75 mg daily). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''For patients with symptomatic cervical artery dissection, [[anticoagulation]] with intravenous [[heparin]] (dose-adjusted to prolong the [[partial thromboplastin time]] to 1.5 to 2.0 times the control value) followed by [[warfarin]] (dose-adjusted to achieve a target [[INR]] of 2.5 [range 2.0 to 3.0]), [[low-molecular-weight heparin]] (in the dose recommended for treatment of [[venous thromboembolism]] with the selected agent) followed by [[warfarin]] (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), or oral anticoagulation without antecedent heparin can be beneficial for 3 to 6 months, followed by [[antiplatelet therapy]] with [[aspirin]] (81 to 325 mg daily) or [[clopidogrel]] (75 mg daily). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
| Line 23: | Line 25: | ||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''Carotid angioplasty and stenting might be considered when ischemic neurological symptoms have not responded to [[antithrombotic therapy]] after acute [[carotid dissection]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''The safety and effectiveness of pharmacological therapy with a [[beta-adrenergic antagonist]], [[angiotensin inhibitor]], or nondihydropyridine [[calcium channel antagonist]] ([[verapamil]] or [[diltiazem]]) to lower blood pressure to the normal range and reduce arterial wall stress are not well established ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
==References== | |||
{{Reflist|2}} | |||
[[Category:Neurology]] | |||
[[Category:Cardiovascular diseases]] | |||
[[Category:Cardiology]] | |||
[[Category:Emergency medicine]] | |||
{{WH}} | |||
{{WS}} | |||
Latest revision as of 19:06, 31 October 2016
|
Carotid artery stenosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
ACC/AHA Guideline Recommendations |
|
Periprocedural Management of Patients Undergoing Carotid Endarterectomy |
|
Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease |
|
Occlusive Disease of the Subclavian and Brachiocephalic Arteries |
|
Case Studies |
|
Patients With Cervical Artery Dissection On the Web |
|
American Roentgen Ray Society Images of Patients With Cervical Artery Dissection |
|
Risk calculators and risk factors for Patients With Cervical Artery Dissection |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Cervical Artery Dissection
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)[1]
Recommendations for Management of Patients With Cervical Artery Dissection
| Class I |
| "1.Contrast-enhanced CTA, MRA, and catheter-based contrast angiography are useful for diagnosis of cervical artery dissection. (Level of Evidence: C)" |
| Class IIa |
| "1.For patients with symptomatic cervical artery dissection, anticoagulation with intravenous heparin (dose-adjusted to prolong the partial thromboplastin time to 1.5 to 2.0 times the control value) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), low-molecular-weight heparin (in the dose recommended for treatment of venous thromboembolism with the selected agent) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), or oral anticoagulation without antecedent heparin can be beneficial for 3 to 6 months, followed by antiplatelet therapy with aspirin (81 to 325 mg daily) or clopidogrel (75 mg daily). (Level of Evidence: C) " |
| Class IIb |
| "1.Carotid angioplasty and stenting might be considered when ischemic neurological symptoms have not responded to antithrombotic therapy after acute carotid dissection. (Level of Evidence: C) " |
| "2.The safety and effectiveness of pharmacological therapy with a beta-adrenergic antagonist, angiotensin inhibitor, or nondihydropyridine calcium channel antagonist (verapamil or diltiazem) to lower blood pressure to the normal range and reduce arterial wall stress are not well established (Level of Evidence: C) " |
References
- ↑ 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.