PAD pt 2 highlights

Question 1

Carotid auscultation is _________ useful to diagnose or r/o carotid artery stenosis

Answer 1

not

Question 2

Carotid stenosis:
Both motor and sensory symptoms may be caused by what?

Answer 2

Anterior circulation Internal carotid artery sourced emboli

Question 3

Carotid stenosis:
Internal carotid artery sourced emboli may cause what?

Answer 3

Amaurosis fugax – transient blindness

Question 4

Carotid stenosis:
Posterior circulation symptoms usually due to what?

Answer 4

vertebral basilar disease

Question 5

Most common pathology associated with internal carotid artery sourced emboli are what 2 things?

Answer 5

1) Anterior circulation (sensory and motor Sx)
2) Amaurosis fugax

Question 6

What are the 2 main parts of carotid stenosis in asymptomatic pts?

Answer 6

1) ASA
2) Statins
[both daily]

Question 7

List 2 Carotid stenosis intervention complications. Which is most common?

Answer 7

1) Cranial nerve injuries = most common
2) Stroke

Question 8

BLUF:
Carotid revascularization with carotid endarterectomy or carotid artery stenting is recommended for symptomatic patients with > _____% internal carotid stenosis

Answer 8

50%

Question 9

Give the BLUF for carotid stenosis

Answer 9

1) Don’t screen asymptomatic adults for carotid stenosis
Auscultation or US
2) Carotid revascularization with carotid endarterectomy or carotid artery stenting is recommended for symptomatic patients with > 50% internal carotid stenosis
3) Carotid artery stenting is preferred in patients with multiple comorbidities, tracheostomy, or previous neck radiation or dissection
4) In patients > 70 y/o, carotid endarterectomy is associated with lower risk of periprocedural stroke or death than carotid artery stenting