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Carotid Artery Stenosis

Checked: 23-05-2020 by Rob Adams Next Review: 23-05-2021

Overview

Carotid Artery Stenosis is a cause of TIA, stroke and monocular visual loss (Amarosis Fugax). Carotid stenosis can also less frequently cause painful ocular ischaemia.

See also the following professional guide to Carotid Artery Stenosis.

Dizziness and vertigo is not a vascular diagnosis; therefore there is no indication to perform a carotid duplex scan. See ‘Dizziness and Vertigo’ guidance on Remedy.

Red Flags

Carotid Artery Stenosis is normally diagnosed following a Stroke or TIA and these patients should be referred immediately via usual pathways. If carotid artery stenosis is then diagnosied then patients are referred onto the vascular team internally.

Who to Refer

Asymptomatic disease may be found incidentally and referral is then only required if stenosis ≥70% and age ≤75 years and patient is otherwise in good health.

CVD risk factors should be addressed including:

BNSSG Antiplatelet guidelines

BNSSG Statin guidelines

Surgical treatment, if required, is normally Carotid Endarterectomy of Carotid Artery Stent (rarely).

Referral

Refer patients with asymptomatic disease if criteria are met to vascular via e-RS Triage service for a routine appointment.

Resources

Please see the local Vascular Directory of Services



Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.