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The Treatment of Carotid Disease: Carotid Endarterectomy vs. Carotid Artery Stenting


1. Which of the tests below is the best screening test to detect a significant carotid stenosis in a patient with an asymptomatic bruit?

a. Cerebral arteriography

b. CAT scan of the neck and head

c. Carotid Duplex scanning

d. Electroencephalography



2. A patient with an asymptomatic 50% carotid stenosis and a contralateral symptomatic 90% carotid stenosis would receive which of the following?

a. 75mg of Plavix daily and no carotid intervention

b. Bilateral carotid endarterectomy(CEA)

c. Carotid endarterectomy of only the symptomatic side

d. Carotid artery stenting(CAS) of both sides in a staged one week interval



3. Which lesion is ideally treated with carotid artery stenting?

a. Acute occlusion of the carotid

b. Symptomatic 80% carotid stenosis in a patient with prior neck radiation.

c. A 99% stenosis in a carotid artery with severe tortuosity

d. A 60% carotid stenosis with free floating thrombus



4. The 30-day stroke rate for CAS in the SAPPHIRE Trial was?

a. 6%

b. 3.6%

c. 2.3%

d. 7%



5. Who published an article that determined that carotid embolus and not occlusion was the most likely cause of most strokes?

a. DeBakey

b. Eastcott

c. Pickering

d. Miller



6. The NASCET showed which patients benefited from CEA?

a. Asymptomatic 80% carotid stenosis

b. A completely occluded carotid artery

c. Symptomatic 80% carotid stenosis

d. 50% carotid stenosis with ulcerated plaque



7. The Endarterectomy versus Stenting in patients with Symptomatic Severe Carotid Stenosis showed a 30-day risk of stroke for CAS and CEA respectively of which?

a.  9.6% and 3.9%

b. 5.1% and 8%

c. 2.5% and 4%

d. 6% and 2%



8. Complications of CAS include all of the following except for?

a. Bradycardia

b. Stent thrombosis

c. Embolization

d. Cranial nerve injury



9. The American Heart Association guidelines state the CEA are proven to be of benefit in which patients?

a. Symptomatic with an acute carotid occlusion

b. Asymptomatic with 50% carotid stenosis

c. TIA's with a <50% carotid stenosis

d. One or more TIA's in the last 6 months with a carotid stenosis of > 70% stenosis



10. The American Heart Association guidelines state that CEA is uncertain to be of benefit in which patients?

a. Asymptomatic with an ulcerated plaque and a <60% carotid stenosis

b. Symptomatic with a >70% carotid stenosis in a healthy patient

c. Asymptomatic with a >70% carotid stenosis

d. Mild stroke within 6 months and a > 70% stenosis





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