Carotid artery stenosis: Difference between revisions

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==Diagnosis==
==Diagnosis==


==Ultrasound Criteria for Carotid Artery Stenosis==
*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==
==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)==
==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)==

Revision as of 16:32, 1 October 2012

For patient information, click here

Carotid artery stenosis
ICD-10 I65.2
ICD-9 433.1
DiseasesDB 31178
MeSH D016893

Carotid artery stenosis Microchapters

Home

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

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Powerpoint slides

Images

American Roentgen Ray Society Images of Carotid artery stenosis

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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

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


Diagnosis

Cardiac MRI

ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance[1] (DO NOT EDIT)

“

CMR may be used for defining the location and extent of carotid arterial stenoses.

”

Treatment

Options for treatment include:

Examples


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Related Chapters

References

  1. ↑ American College of Cardiology Foundation Task Force on Expert Consensus Documents. Hundley WG, Bluemke DA, Finn JP, Flamm SD, Fogel MA; et al. (2010). "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". Circulation. 121 (22): 2462–508. doi:10.1161/CIR.0b013e3181d44a8f. PMC 3034132. PMID 20479157.

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