Extracranial Cerebrovascular Disease

Abstract

Stroke is the third leading cause of death in the United States; during the first stroke approximately 20–30% of patients will die. At least 25% of patients will have a second stroke with a mortality of approximately 60%. Most strokes (80%) are ischemic in nature and, of these, 80% are due to carotid artery stenoses or plaques which embolize. The remaining 20% of ischemic strokes are due to a recent myocardial infarction, arrhythmia, or paradoxical emboli. Twenty percent of strokes are hemorrhagic in nature and result from uncontrolled hypertension or arterio-venous malformations. Evaluation of the carotid artery is best performed with duplex scanning and digital angiography.