Carotid artery stenosis

Case contributed by Dr Bruno Di Muzio

Presentation

Previous episodes of TIA.

Patient Data

Age: 75
Gender: Female
CT

CT Neck angiogram

There are tortuosity and kinking of the proximal left subclavian artery, brachiocephalic artery and proximal right common carotid artery. Atheromatous mixed plaques promote stenosis in the transition of common carotid arteries to the internal carotid arteries:

Right ICA stenosis = ~50%

Left ICA stenosis = >80%

Right vertebral artery is dominant with left vertebral artery finishing as left PICA (hypoplastic). 

Case Discussion

Carotid artery stenosis is usually caused by an atherosclerotic process and is one of the major causes of stroke and transient ischemic attack (TIA), such as in this case. 

This case was approached using the criteria proposed by the North American Symptomatic Carotid Endarterectomy Trial (NASCET), which demonstrated a conclusive benefit for carotid endarterectomy in patients with symptomatic 70-99% ICA stenosis.

 

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Case information

rID: 40265
Case created: 15th Oct 2015
Last edited: 7th Nov 2015
System: Vascular
Inclusion in quiz mode: Included

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