Patients With Cervical Artery Dissection

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Carotid artery stenosis Microchapters

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Patient Information

Overview

Historical Perspective

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Pathophysiology

Causes

Differentiating Carotid artery stenosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Testing Guidelines

History and Symptoms

Physical Examination

Laboratory Findings

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MRA

Echocardiography or Ultrasound

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

ACC/AHA Guideline Recommendations

Diagnostic Testing Guidelines Recommendation

Primary Prevention and Screening Guidelines Recommendations

Secondary Prevention Guidelines Recommendations

Selection of Patients for Carotid Revascularization

Periprocedural Management of Patients Undergoing Carotid Endarterectomy

Management of Patients Undergoing Carotid Artery Stenting

Restenosis After Carotid Endarterectomy or Stenting

Vascular Imaging in Patients With Vertebral Artery Disease

Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease

Occlusive Disease of the Subclavian and Brachiocephalic Arteries

Fibromuscular Dysplasia

Cervical Artery Dissection

Case Studies

Case #1

Patients With Cervical Artery Dissection On the Web

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Risk calculators and risk factors for Patients With Cervical Artery Dissection

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Class I
"1.

1. Contrast-enhanced CTA, MRA, and catheter-based contrast angiog- raphy are useful for diagnosis of cervical artery dissection. (Level of Evidence: C)"

Class IIa
"1.For patients with symptomatic cervical artery dissection, anticoagulation with intravenous heparin (dose-adjusted to prolong the partial thromboplastin time to 1.5 to 2.0 times the control value) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), low-molecular-weight heparin (in the dose recommended for treatment of venous thromboembolism with the selected agent) followed by warfarin (dose-adjusted to achieve a target INR of 2.5 [range 2.0 to 3.0]), or oral anticoagulation without antecedent heparin can be beneficial for 3 to 6 months, followed by antiplatelet therapy with aspirin (81 to 325 mg daily) or clopidogrel (75 mg daily). (Level of Evidence: C) "
Class IIb
"1. Duplex carotid ultrasonography might be considered for patients with nonspecific neurological symptoms when cerebral ischemia is a plausible cause. (Level of Evidence: C) "
"2. When complete carotid arterial occlusion is suggested by duplex ultrasonography, MRA, or CTA in patients with retinal or hemispheric neurological symptoms of suspected ischemic origin, catheter-based contrast angiography may be considered to determine whether the arterial lumen is sufficiently patent to permit carotid revascularization. (Level of Evidence: C) "
"3. Catheter-based angiography may be reasonable in patients with renal dysfunction to limit the amount of radiographic contrast material required for definitive imaging for evaluation of a single vascular territory. (Level of Evidence: C) "