Please enable JavaScript.

Coggle requires JavaScript to display documents.

Carotid Artery Disease (Viva (Hx (Previous TIA: esp. amaurosis fugax …

- - - - Full peripheral vascular examination
        
        Neurological examination: cerebrovascular event
- - - - Urine dip: proteinuria in renovascular disease
      - ECG: ischaemic changes, AF
    - - FBC: anaemia may worsen symptoms
      - U+E: renovascular disease
      - Glucose: DM
      - Lipids: hypercholesterolaemia
    - - Carotid Duplex US: site and size of stenosis
      - MRA: more detailed carotid anatomy
      - Echo: CVD
      - CT or MRI brain: infarcts
  - - - Sudden neurological deficit of vascular origin lasting <24h (usually lasts <1h) w/ complete recovery
      - Microemboli from the plaque
    - - Sudden neuro deficit of vascular origin lasting >24h
      - 3rd leading cause of death in the West
      - Carotid atheroembolism is the commonest cause
  - - - Aspirin or clopidogrel
      - Control risk factors
    - - Symptomatic (ECST, NASCET)
        
        ≥70% (5% stroke risk per yr)
        
        ≥50% if low risk (<3%, typically <75yrs)
        
        6 fold reduction in stroke rate @ 3yrs
      - Asymptomatic (ACAS, ACST)
        ≥60% benefit if low risk
      - Complications
        
        3% risk of stroke or death
        
        Haematoma
        
        MI
        
        Nerve injury
        
        Hypoglossal: ipsilateral tongue deviation
        
        Great auricular: numb ear lobe
        
        Recurrent laryngeal: hoarse voice, bovine cough