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Chapter 57. Carotid and Vertebral Artery Intervention

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What is the most common pathophysiology for acute stroke?

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A. Carotid artery occlusion

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B. Rupture of an intracranial vessel with hemorrhage

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C. Atheroembolic occlusion of a cerebral artery

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D. Thrombotic embolization to a cerebral artery

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The correct answer is C

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The most cause of acute ischemic stroke is atheroembolism, usually vessel-to-vessel embolization.

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Which of the following is true regarding patients with asymptomatic carotid artery stenosis?

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A. Revascularization is not indicated for <50% stenosis.

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B. The annual risk of stroke is 5% per year.

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C. At the end of 4 years of follow-up in the CREST trial, there were more strokes in the stent group compared to the surgical group.

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D. Ulcerations of atherosclerotic carotid plaque double the risk of stroke.

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The correct answer is A

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There is no indication for revascularization of mildly narrow carotid arteries. The annual risk of stroke is estimated at 1% per year. There was no statistical difference between stent or surgery for all strokes at the end of 4 years. Ulcerations increase the risk of stroke by 30%.

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Which of the following statements is true regarding carotid artery disease?

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A. Symptomatic patients are at greater risk than asymptomatic patients.

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B. An asymptomatic patient with a >80% carotid stenosis has a 10% per year risk of stroke.

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C. Dual antiplatelet therapy is more effective in preventing strokes than aspirin therapy.

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D. Aspirin doses of 325 mg/d are more effective than 81 mg/d for stroke prevention.

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The correct answer is A

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Symptomatic patients are at much greater risk than asymptomatic patients. The risk of stroke for a >80% stenosis on modern medical therapy is not known. Neither dual antiplatelet therapy nor doses of aspirin higher than 81 mg/d are more effective at stroke prevention.

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Which of the following characteristics puts a patient with carotid stenosis undergoing carotid stenting at the highest risk?

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A. Age >80 years

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B. Heavily calcified artery

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C. Lesion ulceration

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D. Tortuosity of the aortic arch (type ...

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