Management of Carotid Artery Disease
Carotid artery stenosis (CAS) may cause 20% of ischemic strokes. Which patients are at risk, which should be screened—and what treatment option is most suitable for your patient with CAS?
The AHA/ASA researchers also recommend antiplatelet agents (aspirin, clopidogrel, and/or dipyridamole) for patients with a history of TIA or noncardioembolic ischemic stroke. The guidelines advise moderate alcohol consumption, weight reduction for obese patients, and increased physical activity. Smoking cessation remains the sine qua non of vascular disease management.1,25
Conclusion
Primary care providers play a pivotal role in identifying patients at risk for carotid artery disease and educating them about current treatment options. They have an opportunity to take a proactive role in screening patients (age 55 and over) who smoke or who have diabetes, high blood pressure, high cholesterol, or coronary artery disease.
Detection of moderate to severe CAS can lead to timely surgical intervention in asymptomatic individuals who may not realize they are at risk. Attentive medical and lifestyle management enhances the treatment of carotid disease and reduces the risk of stroke, its most devastating consequence.
