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Clinical guidelines (such as those of the American Heart Association (AHA) [28] and National Institute for Clinical Excellence (NICE) [29]) recommend that all patients with carotid stenosis be given medications to control their vascular risk factors, usually blood pressure lowering medications (if they have hypertension), diabetes medication ...
Carotid endarterectomy is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (i.e., be symptomatic), or be found by a doctor in the absence of symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients.
Led by Brajesh, this study identified that so called “asymptomatic” carotid stenosis actually has a negative impact on cognitive function. [26] The study also introduced a novel 3D ultrasound technique to assess carotid plaque morphology, including its geometry and tissue composition.
The most common of cerebrovascular conditions treated by vascular surgeons is carotid artery stenosis which is a narrowing of the carotid arteries and may be either clinically symptomatic or asymptomatic (silent). Carotid artery stenosis is caused by atherosclerosis whereby the buildup of atheromatous plaque inside the artery causes narrowing.
On the basis of this study and the work on plaque characterisation it has become possible to identify a high risk group of patients with asymptomatic carotid stenosis (5.5% stroke rate per year), but most important has been the identification of a low risk group with an annual stroke risk of less than 1%, that can be spared from unnecessary ...
Testing for coronary artery disease or carotid artery disease is of unclear benefit. [20] While PAD is a risk factor for abdominal aortic aneurysms (AAA), there is no data on screening individuals with asymptomatic PAD for abdominal aortic aneurysms. [20] For people with symptomatic PAD, screening by ultrasound for AAA is not unreasonable. [20]
Carotid artery stenting is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke. It is used to treat narrowing of the carotid artery in high-risk patients, when carotid endarterectomy is considered too risky.
Many carotid bruits are discovered incidentally in an otherwise asymptomatic patient. The presence of a carotid bruit alone does not necessarily indicate the presence of stenosis, and the physical examination cannot be used to estimate the degree of stenosis, if present; therefore, any bruit must be evaluated by ultrasound or imaging. [4]