Carotid artery stenosis diagnostic testing guidelines: Difference between revisions
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' CTA, MRA or elective cerebral angiography can be useful to search for intracranial vascular disease when an extracranial source of ischemia is not identified or to evaluate severity of stenosis and identify intrathoracic or intracranial vascular lesions not adequately assessed by ultrasonography. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' CTA, MRA or elective cerebral angiography can be useful to search for intracranial vascular disease when an extracranial source of ischemia is not identified or to evaluate severity of stenosis and identify intrathoracic or intracranial vascular lesions not adequately assessed by ultrasonography. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Catheter-based angiography can be useful when noninvasive imaging is not sufficient. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Catheter-based angiography can be useful when noninvasive imaging is not sufficient. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' MRA without contrast is reasonable to assess extent of disease in patients with renal insufficiency or extensive vascular calcification. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' MRA without contrast is reasonable to assess extent of disease in patients with renal insufficiency or extensive vascular calcification. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' CTA is reasonable in patients who are not candidates for MRA because of claustrophobia, implanted pacemakers, or other incompatible devices. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' CTA is reasonable in patients who are not candidates for MRA because of claustrophobia, implanted pacemakers, or other incompatible devices. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
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Revision as of 13:29, 3 October 2012
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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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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]
Overview
Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Diagnostic Testing in Patients With Symptoms or Signs of Extracranial Carotid Artery Disease[1] (DO NOT EDIT)
| “ |
Class IIa
Class IIb
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” |
| Class I |
| "1. Noninvasive imaging for detection of ECVD is recommended in the initial evaluation of patients with transient retinal or hemispheric neurological symptoms of possible ischemic origin. (Level of Evidence: C) " |
| "2. Duplex ultrasonography is recommended to detect carotid stenosis in patients who develop focal neurological symptoms corresponding to the internal carotid artery territory. (Level of Evidence: C) " |
| "3. In patients with acute, focal ischemic neurological symptoms corresponding to the territory supplied by the left or right internal carotid artery, magnetic resonance angiography (MRA) or computed tomography angiography (CTA) is indicated to detect carotid stenosis when definitive sonography cannot be obtained. (Level of Evidence: C) " |
| "4. When intracranial or ECVD is not severe enough to account for neurological symptoms of suspected ischemic origin, echocardiography should be performed seeking a source of cardiogenic embolism. (Level of Evidence: C) " |
- In revascularization candidates
| Class IIa |
| "1. MRA or CTA can be useful when carotid duplex ultrasonography is nondiagnostic.(Level of Evidence: C) " |
| "1. CTA, MRA or elective cerebral angiography can be useful to search for intracranial vascular disease when an extracranial source of ischemia is not identified or to evaluate severity of stenosis and identify intrathoracic or intracranial vascular lesions not adequately assessed by ultrasonography. (Level of Evidence: C) " |
| "1. Catheter-based angiography can be useful when noninvasive imaging is not sufficient. (Level of Evidence: C) " |
| "1. MRA without contrast is reasonable to assess extent of disease in patients with renal insufficiency or extensive vascular calcification. (Level of Evidence: C) " |
| "1. CTA is reasonable in patients who are not candidates for MRA because of claustrophobia, implanted pacemakers, or other incompatible devices. (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.