Materiały źródłowe

• #1 Carotid Artery Stenosis: Causes, Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/16845-carotid-artery-disease-carotid-artery-stenosis

  Carotid artery stenosis is a condition that can lead to stroke. […] Carotid artery stenosis is often diagnosed after you’ve experienced symptoms of a stroke. […] There are several tests providers use to confirm a diagnosis of carotid artery stenosis and learn more about the size and location of the blockage. […] Carotid artery stenosis can be dangerous if it’s not caught and treated quickly. […] Quick treatment of carotid artery stenosis can be lifesaving.

• #2 Carotid artery stenosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/carotid-artery-stenosis?lang=us

  Carotid artery stenosis, also known as internal carotid artery stenosis or extracranial carotid artery stenosis, is usually caused by an atherosclerotic process and is one of the major causes of stroke and transient ischemic attack (TIA). […] This article refers to stenosis involving the carotid bulb and the proximal segment of internal carotid artery (ICA), as both are the most common sites of symptomatic and clinically relevant stenosis. […] Atherosclerotic carotid arterial disease accounts for ~15% of all ischemic strokes and TIAs. […] The annual incidence of extracranial carotid artery stenosis as a cause of stroke accounts for ~13 per 100,000 population in the USA. […] Carotid artery stenosis can result in wide-ranging symptoms from ischemic stroke or transient ischemic attack.

• #3 Carotid Artery Disease: Causes, Symptoms, Diagnosis, Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/heart-vascular/vascular-disease/carotid-artery-disease

  Our vascular surgeons work together with a multidisciplinary team that includes neurologists and interventionalists to provide optimal care to patients with carotid artery disease. […] Getting an accurate, early diagnosis offers patients the best chance for a successful outcome. We offer free screenings for those at risk for carotid artery disease so we can diagnose disease early and give our patient the best chance for long-term success. […] A health care provider may suspect carotid artery disease when listening to your arteries with a stethoscope. The blocked artery often makes a whooshing sound known as a bruit. If you have a bruit, you will need a test called a carotid ultrasound. This test uses sound waves to create a picture of the inside of your arteries. This shows how much the arteries have narrowed. In some cases, other imaging tests may be needed. You’ll also need other tests if you have symptoms of a stroke.

• #4 Carotid artery disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carotid-artery-disease/diagnosis-treatment/drc-20360527

  A Mayo Clinic neurologist converses with a woman about a possible carotid artery disease diagnosis. […] Diagnosis usually starts with a medical history and physical exam. The exam generally includes listening for a swooshing sound, known as bruit, over the carotid artery in the neck. A narrowed artery causes the sound. The next step might be a test of physical and mental abilities such as strength, memory and speech. […] These might include: Ultrasound. This looks at blood flow and pressure in the carotid arteries. […] CT or MRI. These can show if there’s been a stroke or other issues. […] CT angiography or MR angiography. These give more information about blood flow in the carotid arteries. These scans make images of the neck and brain after a contrast dye is put into a blood vessel. The dye makes areas of the images stand out.

• #5 Diagnosing Carotid Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/carotid-artery-disease/diagnosis

  In carotid artery disease, there is a narrowing, or stenosis, of one or both of the carotid arteries, which are the two main arteries in the neck that supply blood and oxygen to the brain. […] Some people with carotid artery disease experience no obvious symptoms, even when they have severe blockages. Such blockages may be discovered accidentally, particularly during routine imaging or screening tests for other conditions, such as diabetes and hypertension, which increase the risk of heart attack or stroke. […] However, some people with carotid artery disease experience a stroke or ministroke as the first sign of this condition. […] In diagnosing carotid artery disease, your NYU Langone doctor performs a physical examination. This includes listening to the carotid arteries with a stethoscope for signs of bruit, a whooshing sound caused by irregular blood flow, which can be heard when the carotid arteries are significantly blocked.

• #6 Carotid Artery Disease: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/carotid-artery-disease-causes-symptoms-tests-and-treatment

  How Is Carotid Artery Disease Diagnosed? There are often no symptoms of carotid artery disease until you have a TIA or stroke. Thats why its important to see your doctor regularly for physical exams. Your doctor may listen to the arteries in your neck with a stethoscope. If an abnormal sound, called a bruit, is heard over an artery, it may reflect turbulent blood flow. That could indicate carotid artery disease. […] Your doctor may also use a test to diagnose carotid artery disease. Possible tests include the following: Carotid ultrasound (standard or Doppler). This non-invasive, painless screening test uses high-frequency sound waves to view the carotid arteries. It looks for plaques and blood clots and determines whether the arteries are narrowed or blocked. A Doppler ultrasound shows the movement of blood through the blood vessels. Ultrasound imaging does not use X-rays.

• #7 Carotid Artery Disease

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/carotid-artery-disease/

  Carotid artery disease may occur suddenly (acute) or develop gradually (chronic). […] Carotid artery disease is similar to coronary artery disease, in which plaque buildup occurs in the arteries of the heart. […] Your doctor is likely to start with a thorough medical history and physical examination. The exam generally includes listening for a swooshing sound (heart murmur) over the carotid artery in your neck. If this sound is heard over an artery, it may indicate plaque is building up inside the artery. Carotid artery disease may also be detected during an eye examination if your doctor detects a plaque in the artery that supplies the retina. […] After that, you may have one or more of the following diagnostic tests and procedures: Ultrasound, Angiogram, Magnetic resonance imaging (MRI), Computed tomography (CT scan).

• #8 Carotid Artery Disease | Risk Factors, Causes, Symptoms, Diagnosis, Treatment

  https://nwvascular.com/carotid-artery-disease/

  Carotid artery disease puts you at a greater risk of having a stroke. […] The carotid arteries, located in the neck, are the main source of blood supply to your brain. […] As many as 3% of people over age 65 have carotid artery disease. Your risk increases as you age, and is greater if you have a history of smoking, high blood pressure, high cholesterol, diabetes or heart disease. […] Many people with carotid artery disease (CAD) experience no symptoms, even if the blockage is severe. […] During a routine physical exam, your doctor listens to certain blood vessels using a stethoscope. If a whistling sound is heard, it could indicate plaque build-up in the carotid artery. CAD may also be detected during an eye exam, if your doctor sees plaque in the artery that supplies the retina. […] The surgeon will most likely suggest a carotid artery duplex scan, a non-invasive test which is done using two kinds of ultrasound. This helps determine if the carotid artery is narrowing and provide an accurate estimate of the severity. […] Occasionally the surgeon may recommend alternative tests such as a CT scan, MRI or an angiogram.

• #9 Carotid Artery Stenosis – Diagnosis and Treatment

  https://www.radiologyinfo.org/en/info/carotidstenosis

  Carotid artery stenosis is a narrowing of the large arteries on either side of the neck. […] Your doctor may use carotid ultrasound, CT angiography (CTA), magnetic resonance angiography (MRA), or cerebral angiography to determine the presence, location, and severity of stenosis. […] Carotid artery stenosis sometimes causes an abnormal sound, or bruit, in the artery that your doctor can hear with a stethoscope. Imaging tests to diagnose, localize and measure stenosis include: […] Carotid ultrasound (including Doppler ultrasound): This test uses sound waves to create real-time pictures of the arteries and locate blockages. […] Computed tomography angiography (CTA): CTA uses a CT scanner to produce detailed views of the arteries anywhere in the body in this case, in the neck. […] Magnetic resonance angiography (MRA): This noninvasive test gives information similar to that of CTA without using ionizing radiation. […] Cerebral angiography: Also known as intra-arterial digital subtraction angiography (IADSA), cerebral angiography is a minimally invasive test in which a catheter is guided through an artery in the groin to the area of interest in the brain.

• #10 Diagnosing Carotid Artery Disease | NYU Langone Health

  https://nyulangone.org/conditions/carotid-artery-disease/diagnosis

  Imaging tests may be used to further assess the carotid arteries. Among other details, these tests provide your doctor with information about the extent of a blockage. […] Our doctors use noninvasive duplex ultrasound as the first and most important test to diagnose carotid artery disease. […] Your doctor may order this test to help identify diseased, narrowed, enlarged, and blocked carotid and vertebral arteries. […] Doctors may also recommend a magnetic resonance angiogram, which is a study of the blood vessels using an MRI scan. […] Once more commonly used, a carotid and cerebral angiogram, which involves inserting a hollow tube called a catheter into the carotid arteries and the brain, is rarely required to diagnose carotid artery disease or to determine treatment.

• #11 Carotid ultrasound – Mayo Clinic

  https://www.mayoclinic.org/tests-procedures/carotid-ultrasound/about/pac-20393399

  Carotid (kuh-ROT-id) ultrasound is a procedure that uses sound waves to look at blood flow through the carotid arteries. A carotid ultrasound also checks the thickness of the carotid artery wall and for blood clots. The test can help healthcare professionals see if the carotid arteries are blocked or narrowed. Narrowed arteries increase the risk of stroke. The test results also help your healthcare professional choose a treatment to lower your stroke risk. […] A carotid ultrasound looks for narrowed or blocked carotid arteries, which can increase the risk of stroke. […] Early diagnosis and treatment of a narrowed carotid artery can lower the risk of stroke. […] Your healthcare professional orders a carotid ultrasound if you have a transient ischemic attack (TIA), also called a ministroke.

• #12 Carotid Artery Disease | WakeMed

  https://www.wakemed.org/care-and-services/heart-vascular-care/vascular-services/conditions/carotid-artery-disease

  There are a few tests that can detect carotid diseases. […] Ultrasound can assess blood flow and pressure in the carotid arteries. […] Angiogram provides images of blood flow in the carotid arteries. […] Magnetic resonance imaging (MRI) helps to trace evidence of stroke or other irregularities. […] Upon initial examination, the carotid ultrasound is used for diagnosis. The test involves a high-frequency sound to create images of the insides of two large arteries in your neck, so a cardiologist or vascular surgeon can review their structure and see any plaque buildup. Two ultrasound tests are performed simultaneously: The standard ultrasound provides information about the arteries structure, and the Doppler ultrasound focuses on blood flow. After diagnosis, regular carotid artery ultrasound tests are used to monitor the condition.

• #13 Imaging modalities to diagnose carotid artery stenosis: progress and prospect

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6537161/

  In the past few decades, imaging has been developed to a high level of sophistication. […] Carotid artery stenosis (CAS) may potentially cause debilitating stroke, and its accurate early detection is therefore important. […] DUS is usually the initial recommended CAS diagnostic examination. However, for the therapeutic intervention, either MRA or CTA is recommended for confirmation, and for added information on intracranial cerebral circulation and aortic arch condition for procedural planning. […] In a clinical setting, if physician detects the presence of carotid bruit, an ultrasound examination or CTA/MRA is then prescribed to confirm the presence and severity of carotid stenosis. […] A brief note on the development of potential imaging modalities is also included. […] Characterizing the blood flow in the artery, Doppler ultrasound plays an important role in improving the CAS diagnosis.

• #14 Diagnosis and Treatment of Carotid Artery Stenosis – MedCrave online

  https://medcraveonline.com/JNSK/diagnosis-and-treatment-of-carotid-artery-stenosis.html

  The sensitivity of MRA is 91-95% and the specificity is 88-99%. […] The deficiencies include smaller sensitivity in moderate stenosis, inability to differentiate between subocclusion and occlusion, relatively high price and limited availability as well as fact that in some cases it is difficult to perform, such as patients with severe general condition, patients with claustrophobia or patients with a heart electrostimulator or embedded defibrillator. […] The sensitivity of the CTA procedure is 77% and specificity is 95%. […] Prompt evaluation and triage of patients with symptomatic carotid artery stenosis is essential to minimize the risk of early recurrent cerebrovascular events. […] Indications for the treatment of patients with carotid artery stenosis are based on several aspects of neurological symptomatology and the degree of carotid stenosis, comorbidity as well as high risk for vascular and local anatomical stenosis.

• #15 Imaging modalities to diagnose carotid artery stenosis: progress and prospect

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6537161/

  Changes in the diameter of the carotid artery, because of plaque formation, is visualized in the B-mode images to diagnose CAS. […] Since B-mode diagnosis is dependent on the IMT, an accurate marking of the wall boundaries is a critical factor in the diagnosis. […] Therefore, a trade-off between the computational cost and accuracy is inevitable. […] DSA is the gold standard to diagnose CAS but suffers from the X-ray radiation exposure drawback. […] With optimized X-ray radiation, CTA provides 3D visualization, but is inefficient in evaluating the blood flow velocity. […] DUS is of low cost, but its efficacy is operator dependent. […] In the parallel imaging technological development, potential imaging modalities, like OCT, PAT, and Thermography, are also evolving over time. […] Although successfully studied in ex vivo models, PAT must go a long way in the field of CAS diagnosis.

• #16 Carotid Artery Disease: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/heart-disease/carotid-artery-disease-causes-symptoms-tests-and-treatment

  Magnetic resonance angiography (MRA). This imaging technique uses a powerful magnet to gather accurate information about the brain and arteries. Then a computer uses this information to generate high-resolution images. An MRA can often detect even small strokes in the brain. […] Computerized tomography angiography (CTA). More detailed than an X-ray, a CT uses X-rays and computer technology to produce cross-sectional images of the carotid arteries. Images of the brain can be collected as well. With this imaging test, the scan may reveal areas of damage on the brain. The CT scan uses a low level of radiation. […] Cerebral angiography (carotid angiogram). This procedure is considered the gold standard for imaging the carotid arteries. It is an invasive procedure that lets a doctor see blood flow through the carotid arteries in real-time. Cerebral angiography allows the doctor to see narrowing or blockages on a live X-ray screen as contrast dye is injected into the carotid arteries. This procedure provides the best information. It does carry a small risk of serious complications.

• #17 Carotid Artery Disease | Society for Vascular Surgery

  https://vascular.org/your-vascular-health/vascular-conditions/common-conditions/carotid-artery-disease

  The carotid arteries are the main arteries in your neck that supply blood to your brain. […] Carotid artery disease (CAD) occurs when the carotid arteries become narrowed or blocked due to plaque buildup. This narrowing, also called carotid artery stenosis, can lead to strokes or mini-strokes. […] If your doctor thinks you might have CAD, they will recommend a noninvasive carotid duplex ultrasound exam. The ultrasound results will confirm if you have CAD and its severity. […] If CAD is confirmed or suspected, you may be referred to a vascular surgeon. Vascular surgeons are experts in the diagnosis, medical management, and all of the procedural options (surgery, stents) to treat CAD.

• #18 Carotid artery stenosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/carotid-artery-stenosis?lang=us

  Rarely, severe carotid artery stenosis can result in convexal subarachnoid hemorrhage due to rupture of compensatory pial vessels. […] Conventional angiography has been considered the standard method for evaluating carotid stenosis, moreover, the trials published in the 1990s (NASCET, ECST, and ACAS) were based on this method. […] However, the introduction and development of ultrasound Doppler, CT angiography (CTA), and MRI angiography (MRA) have been replacing angiography for diagnostic purposes, essentially reserving it for endovascular treatment. […] Doppler ultrasound has become the first choice for carotid stenosis screening, permitting the evaluation of both the macroscopic appearance of plaques as well as flow characteristics. […] Hemodynamically significant carotid stenosis is usually referred to a further CTA or MRA study.

• #19 Neurosurgical & Spine Institute of Savannah – About Carotid Artery Disease

  https://neurologicalinstitute.com/expertise/e_carotid.html

  In some cases, carotid artery disease can be detected during a normal physician checkup. In other cases, further testing may be needed. These tests may include ultrasound imaging, CT angiography (CTA), magnetic resonance angiography (MRA), or traditional angiography. Angiography consists of an X-ray of the carotid arteries and arteries of the brain taken by injecting a special dye into the arteries. CTA and MRA are relatively new imaging techniques that avoid most of the risks associated with angiography, however, CTA and MRA images are sometimes not quite as definitive as angiography. […] Carotid endarterectomy is a surgical procedure used to prevent stroke. It involves removing fatty deposits that are blocking one of the two carotid arteries. The surgery has been found highly beneficial for persons who have already had a stroke or experienced the symptoms of a stroke and have a severe stenosis.

• #20

  https://www.nhs.uk/conditions/carotid-endarterectomy/why-its-done/

  You’ll usually have an ultrasound scan first to check if there’s any narrowing in your arteries and determine whether it’s severe enough for you to benefit from having surgery. […] If your arteries are narrowed, you may need to have further tests to confirm the diagnosis, such as a CTA or MRA. […] If tests indicate your carotid arteries are narrowed, the severity of the narrowing (stenosis) will be graded to determine whether you need surgery. […] The National Institute for Health and Care Excellence (NICE) recommends that people who have had a stroke or TIA and have a moderate or severe stenosis should have a carotid endarterectomy. […] You should be assessed within a week of the start of your stroke or TIA symptoms. […] The operation will ideally be carried out within 2 weeks of when your symptoms started.

• #21 Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10250083/

  The current gold standard investigation is a noninvasive duplex ultrasound (DUS), complemented by both computed tomography angiography and magnetic resonance angiography to assess the severity of plaque buildup within the artery. […] This review aims to present research and guidelines from major journals presenting information about CS. […] Efficient diagnosis and classification of CS into first-degree CS 50% stenosed artery, second-degree CS 51-69% stenosed artery, or third-degree CS 70-99% stenosed artery is one of the crucial steps for proper management. […] Digital subtraction angiography (DSA) has been the gold standard for verification of the severity of stenosis. […] DUS appears to be highly useful due to diverse factors. […] Although there are many possible diagnostic processes and options, DUS has been commonly used as a primary procedure due to its multiple immediate benefits and characteristics, including easy attainability, reliable images, and cost-effectiveness.

• #21 Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10250083/

  Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. […] The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. […] Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. […] In order to diagnose a patient for CS, the doctor will perform both a physical exam and order investigations to make a definitive diagnosis. […] In order to diagnose CS, the current gold standard investigation is a noninvasive duplex ultrasound (DUS), complemented by both computed tomography angiography and magnetic resonance angiography to assess the severity of plaque buildup within the artery.

• #22 Carotid artery stenosis: An approach to its diagnosis and management

  https://www1.racgp.org.au/ajgp/2021/november/carotid-artery-stenosis

  CDUS remains the first-line investigation for carotid artery disease, as it is an inexpensive, non-invasive modality that has been shown to be accurate in estimating the degree of stenosis when compared with angiographic measurement. […] The gold standard treatment for symptomatic disease is carotid endarterectomy (CEA), the main goal of surgery being to minimise the risk of recurrent stroke from an unstable plaque, with surgery having no impact on the outcome of the initial stroke. […] The timing of CEA after the neurological event is also critical, as the highest risk of recurrent stroke from a symptomatic ICA plaque is within the first two weeks from the initial event. […] The commencement of best medical therapy (BMT) is the main principle of treatment for asymptomatic disease. […] The role of surgery for asymptomatic disease continues to remain contentious in the vascular surgical community.

• #22 Carotid artery stenosis: An approach to its diagnosis and management

  https://www1.racgp.org.au/ajgp/2021/november/carotid-artery-stenosis

  Carotid artery stenosis (CAS) is one of the major causes of acute ischaemic stroke, accounting for approximately 20% of cases. […] CAS can be classified as symptomatic or asymptomatic disease. […] The benefit of surgery is less clear for asymptomatic disease. […] The other clinical scenario for CAS is asymptomatic disease that may be diagnosed following detection of a carotid bruit or as an incidental finding on imaging. […] Symptomatic CAS relates to an episode of neurological ischaemia that has occurred in the preceding six months and has been linked to a haemodynamically significant ICA stenosis (ie stenosis 50%). […] The natural history is that patients will frequently have either a single or multiple preceding TIA/s prior to a stroke. […] Asymptomatic CAS is the presence of a haemodynamically significant CAS that has not caused an episode of neurological ischaemia in the preceding six months.

• #23

  https://www.nhs.uk/conditions/carotid-endarterectomy/why-its-done/

  Having surgery gives the best chance of preventing a further stroke if it’s performed as soon as possible. […] Surgery is sometimes recommended for people who haven’t previously had a stroke or a TIA but are found to have severe stenosis. […] Surgery isn’t recommended in cases where there’s minor stenosis (less than 50%). […] This is because surgery is most beneficial for people with moderate and severe stenosis (more than 50%). […] The maximum benefit is seen in those with severe stenosis (70 to 99%). […] A carotid endarterectomy isn’t of any benefit for people with a complete blockage of their carotid artery.

• #24 Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10250083/

  The use of local anesthesia is common during CAS. […] According to the guidelines of the Society of Vascular Surgery, in symptomatic patients with 50% stenosis, carotid revascularization should be carried out as soon as the patient is neurologically stable after 48 hours, but most likely before 14 days following the onset of symptoms. […] CEA became the conventionally accepted standard of care for severe (70% stenosis) symptomatic CS after the North American Carotid Endarterectomy Trial (NASCET) was published. […] The management of patients with diabetes is the same as for asymptomatic patients. […] The most common medical treatments for CS are antiplatelet medications (such as aspirin) and statins. […] The risk of these complications associated with CS can be reduced through early diagnosis and treatment, including medical management and/or surgical intervention.

• #25 Diagnosis and Treatment of Carotid Artery Stenosis – MedCrave online

  https://medcraveonline.com/JNSK/diagnosis-and-treatment-of-carotid-artery-stenosis.html

  The results of NASCET studies highlight the key role of CEA in the ICA stenosis measuring over 70%. […] In patients with symptomatic stenosis of 70% to 99%, the absolute risk reduction decreased from 23% to 16% and then to 8% when patients were treated within 2 weeks, between 2 and 4 weeks, and after 4 weeks, respectively. […] The guidelines for secondary stroke prevention recommend that CEA should be performed within 2 weeks for patients presenting with a TIA or minor stroke. […] A medical approach to the treatment of carotid artery stenosis implies a combination of non-invasive procedures consisting of education, changes in habits, healthy eating, dietary measures and drug administration. […] The standard procedure for invasive treatment of carotid artery stenosis is CEA. […] The safety of CAS compared to CEA has been studied in several RCTs.

• #26 Carotid artery stenosis: An approach to its diagnosis and management

  https://www1.racgp.org.au/ajgp/2021/november/carotid-artery-stenosis

  A reasonable approach from a general practice point of view is to refer asymptomatic patients with an ICA stenosis of 80% for a non-urgent vascular surgical review for consideration of surgery. […] CEA is the gold standard for the surgical management of symptomatic CAS and should ideally be carried out within two weeks from the initial event.

• #27 Vascular Surgery: Carotid Artery Disease | GW Medical Faculty Associates

  https://gwdocs.com/specialties/vascular-surgery/carotid-artery-disease

  Atherosclerosis of the carotid arteries is important because it is a major cause of stroke. […] Carotid artery disease is easily checked by Carotid Duplex Ultrasound. This is a simple non-invasive study that can detect plaque in the carotid arteries and determine the degree of blockage. […] While there are many causes of stroke, carotid stenosis is thought to cause about 20-25% of strokes in adults. […] The importance of carotid disease in patients without symptoms of stroke is more controversial. […] Narrowing of the carotid arteries between 50-70% carries a low risk of stroke and should be monitored. […] Patients with symptoms of a stroke or ministroke (TIA) who have a carotid stenosis more than 50% should be considered for intervention. […] All asymptomatic patients with carotid plaque should be treated by control of diabetes, cholesterol, blood pressure and smoking cessation as well as aspirin therapy and a statin.

• #28 Screening for Asymptomatic Carotid Artery Stenosis: Recommendation Statement | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/0515/p614.html

  The USPSTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population. […] The USPSTF continues to recommend against screening for carotid artery stenosis in asymptomatic adults. […] The USPSTF found that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits. […] Using a reaffirmation process, the USPSTF concludes with moderate certainty that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits. […] The USPSTF concludes with moderate certainty that screening for asymptomatic carotid artery stenosis in the general population has no benefit and may be harmful. […] The USPSTF does not recommend screening adults without a history of transient ischemic attack, stroke, or other neurologic signs or symptoms referable to the carotid arteries. […] For patients with asymptomatic disease, the harms of surgical interventions compared with appropriate medical therapy appear to outweigh the benefits.

• #29 Carotid Artery Stenosis Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/417524-overview

  Carotid duplex imaging is performed most commonly in patients with moderate risk factors. […] In symptomatic patients and for those with abnormal carotid ultrasonographic findings, another imaging test is performed. MRA or CTA offers full depiction of the cervical common carotid artery (CCA) and internal carotid artery (ICA). […] The role of cervical-cerebral angiography is evolving as less invasive alternative tests have become available. […] The U.S. Preventive Services Task Force (USPSTF) has issued a recommendation against screening for carotid stenosis in the general population. […] The focus of coronary artery stenosis diagnosis has begun to shift from stenosis quantification to plaque characterization, which has led to development of other potential imaging tools such as optical coherence tomography (OCT), photoacoustic tomography (PAT), and infrared (IR) thermography.

• #30 Carotid Artery Disease Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/carotid-artery-disease/diagnosis.html

  Carotid artery duplex scan […] Magnetic resonance imaging (MRI) […] Magnetic resonance angiography (MRA) […] Computed Tomography Scan (Also called a CT or CAT scan) […] Angiogram or arteriogram […] Your doctor may listen to your neck for a sound called a bruit (pronounced „broo-EE”). This whooshing sound is often heard when a carotid artery is narrowed (stenosis). […] If your doctor thinks you may have stenosis, you will have a Doppler ultrasound. This test uses sound waves to show how blood flows through an artery or vein. You also may have a CT angiogram or a magnetic resonance angiogram (MRA). […] Routine tests for carotid artery disease are not recommended for everyone. Experts recommend them only for people who have symptoms. […] Some companies sell ultrasound screening at shopping malls or other places. But insurance doesn’t pay for these tests because they are not recommended by experts. Plus, your doctor isn’t involved in prescribing the test. So he or she isn’t there to explain the results to you. It’s a good idea to talk to your doctor before having one of these tests.

• #31 Carotid Artery Screening

  https://www.radiologyinfo.org/en/info/screening-carotid

  Screening exams find disease before symptoms begin. The goal of screening is to detect disease at its earliest and most treatable stage. […] In carotid artery screening, individuals who have no signs or symptoms of carotid artery disease undergo ultrasound (US) imaging of the carotid arteries, such as: carotid duplex ultrasound, carotid intima media thickness (IMT) ultrasound. […] Carotid duplex US may be considered for asymptomatic patients who have peripheral artery disease, coronary artery disease, atherosclerotic aortic aneurysm, or at least two risk factors for stroke. […] Carotid IMT US is not universally accepted as a means of screening for carotid artery disease. However, the thickness of the innermost layers of the carotid artery walls is an independent marker for atherosclerosis. […] If your carotid artery screening reveals that you have narrowing of the carotid arteries, hence are at risk of a stroke or other cardiovascular issue, your doctor may recommend one of the following therapies, depending on the severity of blockage in your arteries.

• #32 Carotid Artery Disease Screening Tests – Life Line Screening

  https://www.lifelinescreening.com/screening-services/carotid-artery-disease-screening?srsltid=AfmBOoqwTYPkMDdn7oe6ATRAA5TwpUa0T4S0xaiIXTt16uMHA0CNwgxL

  The best way to check for carotid artery disease is to undergo a screening. Carotid artery screening is conducted via a non-invasive color flow ultrasound in which a technician creates a series of images of the carotid arteries while also measuring blood flow through them. […] If the screening report identifies the buildup of plaque in your carotid arteries, schedule an appointment with your doctor to review the results. Your doctor may order additional tests to confirm a diagnosis of carotid artery disease. […] Early screening can help identify the problem before it is too late, especially in people with risk factors for cardiovascular disease. […] A carotid artery ultrasound is appropriate for all adults age 55+, and adults age 40+ with two or more risk factors for cardiovascular disease. […] Annual screening is recommended for anyone with risk factors for cardiovascular disease, or who has previously undergone a screening that identified the presence of plaque in the arteries. […] Preventive screening can identify plaque buildup in the carotid artery before symptoms appear.

• #33 Imaging modalities to diagnose carotid artery stenosis: progress and prospect | BioMedical Engineering OnLine | Full Text

  https://biomedical-engineering-online.biomedcentral.com/articles/10.1186/s12938-019-0685-7

  DUS is considered to be the preferred choice for initial screening of CAS. […] In future, an active thermography method, wherein external stimulation is done to extract maximum thermal features could be a potential advancement in the field. […] Accuracy of CAS diagnosis has substantially increased over the decades with the progressive technological developments.

• #34 Diagnosis and Treatment of Carotid Artery Stenosis – MedCrave online

  https://medcraveonline.com/JNSK/diagnosis-and-treatment-of-carotid-artery-stenosis.html

  A meta-analysis of published RCTs indicated that the risk of stroke within 30 days of the intervention was slightly higher in the CAS than the CEA group. […] Atherosclerotic stenotic-occlusive carotid artery disease is one of the most common causes of stroke (20-25%). […] This approach includes the use of modern diagnostic methods, medical treatment and surgical or endovascular treatment. […] The selection of treatment options in carotid artery disease should be done by an interdisciplinary team consisting of a neurologist, vascular surgeon, anesthesiologist and intervention radiologist.

• #35 Carotid Artery Disease | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/carotid-artery-disease/

  Vascular surgeons at UT Southwestern Medical Center are renowned for their advanced treatments of carotid artery disease, a condition caused by the buildup of plaque in the arteries. […] Carotid artery disease occurs when fat, cholesterol, calcium, and other substances collectively called plaque clog the two large blood vessels in the neck. These blood vessels are responsible for delivering blood to the brain and head. Blockage increases the risk of stroke, which can cause permanent brain damage or even death. […] UT Southwesterns vascular surgeons are experts at treating carotid artery disease. Our surgeons have in-depth experience performing all carotid procedures, including: […] Imaging tests are the standard way we diagnose carotid artery disease. These include: […] We also collect a patients medical history and conduct a physical exam to help us accurately diagnose the condition.

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