Is it possible that this patient is asymptomatic? The role of multidetector ct angiography in detection of ulcerated plaques in patients with asymptomatic carotid stenosis: Case report
| Autor: | Predrag Gajin, Djordje Radak, Nikola Aleksic, Srdjan Babic, Dario Jocic, Predrag Matic, Slobodan Tanaskovic |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography medicine.medical_treatment lcsh:Medicine internal carotid artery Carotid endarterectomy 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences 0302 clinical medicine medicine.artery Angioplasty Occlusion Multidetector Computed Tomography medicine Humans Carotid Stenosis Common carotid artery cardiovascular diseases Aged medicine.diagnostic_test business.industry lcsh:R Angiography asymptomatic carotid disease General Medicine medicine.disease 3. Good health Surgery Stenosis Carotid Arteries Asymptomatic Diseases cardiovascular system Female Radiology Internal carotid artery medicine.symptom business carotid endarterectomy 030217 neurology & neurosurgery Carotid Artery Internal |
| Zdroj: | Srpski Arhiv za Celokupno Lekarstvo, Vol 143, Iss 9-10, Pp 615-618 (2015) Srpski arhiv za celokupno lekarstvo (2015) 143(9-10):615-618 |
| ISSN: | 2406-0895 0370-8179 |
| Popis: | Introduction. Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT). Case Outline. A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA) stenosis of 50% and the ipsilateral internal carotid artery (ICA) stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA) occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80%) and ICA (>70%) narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion. Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences. [Projekat Ministarstva nauke Republike Srbije, br. 41002] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|