Background: Carotid endarterectomy is effective in reducing recurrent stroke in patients with carotid stenosis. Duplex sonography is widely used for diagnosing internal carotid artery (ICA) stenosis. Surgeons often base management decisions solely on this technique. Published velocimetric criteria should be validated in each laboratory. This study aims to validate Doppler velocimetric criteria ...

The management of carotid artery stenosis reduces the risk of stroke and its related deaths. Management options include risk factor modification and medical therapy, carotid endarterectomy (CEA), and carotid artery stenting (CAS). Although several randomized controlled trials (RCTs), mostly conducted in late-1980s and mid-1990s, have proved CEA to be effective in the prevention of ipsilateral i...

The management of carotid stenosis in women remains a topic of controversy. In this review article, we aimed to define carotid disease burden in women, review outcomes of carotid endarterectomy and carotid artery stenting in women, discuss differences in practice patterns based on sex, and provide guidelines for management of women with carotid stenosis. Symptomatic women with high-grade stenos...

In severe valvular aortic stenosis, obstruction to ventricular contraction results in prolonged ventricular systole and diminished peak flow velocity. This may translate into weak or impalpable peripheral arterial pulses. We report a case of severe aortic stenosis associated with an impalpable carotid pulse (in the absence of local carotid artery disease) that became easily detectable following...

BACKGROUND AND PURPOSE We systematically compared and appraised contemporary guidelines on management of asymptomatic and symptomatic carotid artery stenosis. METHODS We systematically searched for guideline recommendations on carotid endarterectomy (CEA) or carotid angioplasty/stenting (CAS) published in any language between January 1, 2008, and January 28, 2015. Only the latest guideline pe...

Duplex scanning of the carotid bifurcation has emerged as an accurate noninvasive means of predicting and quantifying carotid arterial stenoses. Compared with the more widely reported measurements of spectral broadening and peak frequency ratios, measurements of diastolic velocity ratios have theoretical advantages in predicting carotid artery stenosis. The use of diastolic velocity ratios betw...

One would think that risk factors for transient ischemic attack (TIA) and asymptomatic carotid bruit (ACB) would be similar. In our referral population and in several previously reported cohort populations, however, men outnumber women among patients with TIA. In contrast, women outnumber men among patients with ACB. We found in two independent populations that women with ACB are up to 5.7 time...

BACKGROUND Carotid atherosclerotic disease is recognized as an important risk factor for brain ischemic events. However, high-grade stenosis does not always cause ischemic strokes, whereas moderate-grade stenosis may often cause ischemic strokes. It has been reported that there is an association between carotid intraplaque hemorrhage (IPH) and new cerebral ischemic events. The purpose of this s...

OBJECTIVE To critically examine the role of significant carotid stenosis in the pathogenesis of postoperative stroke following cardiac operations. DESIGN Retrospective cohort study. SETTING Single tertiary care hospital. PARTICIPANTS A total of 4335 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both. MAIN OUTCOME MEASURES Incidence, subtype, and arter...

BACKGROUND Syncope is commonly worked up for carotid stenosis, but only rarely attributed to it. Considering paucity of such cases in literature, we report a case and discuss the pathophysiology. DESIGN/METHODS We report a patient with high-grade bilateral severe internal carotid artery (ICA) stenosis who presented with syncopal episodes in the absence of stroke, orthostatic hypotension, sign...