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Chapter 57. Carotid and Vertebral Artery Intervention

What is the most common pathophysiology for acute stroke?

A. Carotid artery occlusion

B. Rupture of an intracranial vessel with hemorrhage

C. Atheroembolic occlusion of a cerebral artery

D. Thrombotic embolization to a cerebral artery

The correct answer is C

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

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

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

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

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.

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

The correct answer is A

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%.

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

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

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

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

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

The correct answer is A

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.

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

A. Age >80 years

B. Heavily calcified artery

C. Lesion ulceration

D. Tortuosity of the aortic ...

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