Carotid Artery Disease in the Elderly
Extracranial carotid artery disease is the cause of stroke in 14–40% of patients, and artery to artery embolism is the main mechanism of ischaemic stroke. The association of carotid artery disease with coronary artery disease, peripheral vascular disease, atheromatous renal artery stenosis, aortic-iliac occlusive disease and history of cerebrovascular disease is well documented. The finding of an audible carotid bruit in an asymptomatic patient may be the first indication for further evaluation, but they are not a reliable indicator of asymptomatic stenosis. A variety of imaging procedures are available, relatively safe and reliable, and each technique however has its usefulness and its shortcomings. Medical treatment alone is now considered the best treatment for asymptomatic carotid artery stenosis except in those patients who are at risk of stroke.
KeywordsExtracranial carotid artery disease Audible carotid bruit Asymptomatic carotid artery stenosis Carotid endarterectomy (CEA) Percutaneous transluminal carotid angioplasty Carotid stents
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