aneurysms and carotid artery surgery

Question 1

investigations of carotid artery

Answer 1

CT, carotid USS

Question 2

what is measured in carotid artery stenosis

Answer 2

speed of flow not aperture

Question 3

management of carotid artery stenosis (TIA)

Answer 3

best medical therapy- smoking cessation, antiplatelet, statin, diabetic control, control of hypertension, imaging- CT, carotid doppler and or CT angiogram

Question 4

be careful of what nerves

Answer 4

vagus nerve just behind carotid, hypoglossal nerve runs across bifurcation of artery and can’t move tongue if damaged

Question 5

when to do surgery for TIA

Answer 5

if it is less than 50% stenosed then no point in surgery but if more than 50% then dramatic benefit, absolute risk reduction of 17% for stroke in 2 years following CEA compared to best medical therapy. if asymptomatic then risk is not worth it

Question 6

NNT to prevent one stroke at 5 years

Answer 6

9 for men, 36 for women

Question 7

most risky period for further event is

Answer 7

within first 2 weeks of first event

Question 8

surgery is ____ in management of TIA

Answer 8

prophylactic