Book chapter
27 Imaging of the Cervical Carotid Artery for Atherosclerotic Stenosis
Evidence-Based Imaging, pp.451-464
Springer New York
03/16/2011
DOI: 10.1007/978-1-4419-7777-9_27
Abstract
At present, carotid imaging is performed to identify the presence and measure the degree of atherosclerotic stenosis, in order to select appropriate candidates for surgical endarterectomy (strong evidence). Several different imaging strategies may be employed in symptomatic patients: Catheter angiography (CA) may be used for this purpose (strong evidence). Doppler ultrasound (DUS), magnetic resonance angiography (MRA), and computed tomography angiography(CTA), or some combination, if adequately validated, may be used to screen patients (those with less than 50% stenosis) prior to CA (moderate evidence). Doppler ultrasound, MRA, and CTA, or some combination, if adequately validated, may be used to identify patients with severe stenosis (greater than 80%) for surgical endarterectomy (moderate evidence). Screening of asymptomatic patients with noninvasive methods and highly specific thresholds may be cost-effective in certain high-risk populations, such as patients with known atherosclerotic disease in other circulations or the presence of bruit over the carotid artery on physical examination (moderate evidence). More information regarding the safety and efficacy of angioplasty and stenting relative to surgical endarterectomy is expected in the near future. As treatment may be incorporated into the diagnostic catheter angiographic procedure, these recommendations may be revised. Physiologic imaging tools identify higher-risk subgroups in patients with atherosclerotic carotid stenosis and occlusion (strong evidence). The use of these physiologic imaging tools to improve guide therapy and improve outcome is unproven (insufficient evidence). A randomized clinical trial is underway for surgical revascularization of carotid occlusion in patients selected by positron emission tomography (PET).
Details
- Title: Subtitle
- 27 Imaging of the Cervical Carotid Artery for Atherosclerotic Stenosis
- Creators
- Alex M BarrocasColin P Derdeyn - Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, USA
- Resource Type
- Book chapter
- Publication Details
- Evidence-Based Imaging, pp.451-464
- DOI
- 10.1007/978-1-4419-7777-9_27
- Publisher
- Springer New York; New York, NY
- Language
- English
- Date published
- 03/16/2011
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984071636502771
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