← All quick references
ClearRounds Health · Cardiology · Quick Reference
Carotid Stenosis
PDF coming soon
Vascular & ThromboembolicIntermediateIn progressOne-page PDF
Asymptomatic vs symptomatic stenosis, ultrasound thresholds, medical therapy, CTA/MRA, vascular referral.
Last reviewed
Pending initial clinical review
Sources / guidelines to verify
- 2021 AHA/ASA & SVS extracranial carotid disease guidelines
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.
One-page reference
Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.
1
What it is / why it matters
- Atherosclerotic internal-carotid narrowing → stroke risk.
- Symptomatic (ipsilateral TIA/stroke) vs asymptomatic — management differs.
2
Key diagnostic clues
- Carotid bruit (insensitive), amaurosis fugax, or hemispheric TIA; often found on imaging.
3
Initial workup
- Carotid duplex for degree of stenosis; confirm/characterize with CTA or MRA.
- Brain imaging if symptomatic.
4
Management framework
- Intensive medical therapy for all: high-intensity statin (LDL <70), antiplatelet, BP, smoking, diabetes.
- Symptomatic ≥50–70% → revascularization (CEA or CAS), ideally within 2 weeks.
- Asymptomatic high-grade (≥70%) → consider in selected patients with good life expectancy.
5
Red flags / escalate now
- Crescendo TIA or acute stroke symptoms → emergent stroke pathway; symptomatic high-grade → expedited referral.
6
Follow-up / monitoring
- Duplex surveillance; risk-factor goals.
7
Clinic pearls
- Symptomatic stenosis benefits most from prompt revascularization (≤2 weeks).
- Asymptomatic management increasingly favors intensive medical therapy.
Related quick references
Suggest an edit or request this reference
Spot something to improve, or want this one-pager prioritized? Send feedback to the ClearRounds Health team.
Share feedback →