Abstract
Article: Common Carotid Artery Occlusion With Retrograde Flow in the Internal Carotid Artery
Authors: Megan A. White, BMRSc, RVT, CRGS, CRVS, Santanu Chakraborty, MRCP, FRCR
Category: Vascular
Credit: 1.0 SDMS CME Credit
Objectives: After studying the article entitled “Common Carotid Artery Occlusion With Retrograde Flow in the Internal Carotid Artery,” you will be able to:
Optimize machine settings for detection of carotid artery occlusion
Apply diagnostic criteria for total carotid artery occlusions
Appropriately document hemodynamics distal to a common carotid artery (CCA) occlusion
The most common cause of CCA occlusion is
Dissection Cardiac embolism Atherosclerosis Giant cell arteritis
The prevalence of CCA occlusion in patients with carotid artery atherosclerotic disease is
<1% 2%–5% 5%–7% >8%
The overall accuracy of duplex sonography in diagnosing total CCA occlusion is
<80% <90% 90%–95% >95%
The typical clinical presentation of a total CCA occlusion is
Stroke Transient ischemic attack Amaurosis fugax Any of a variety of symptoms, or may be asymptomatic
The most common site of atherosclerotic disease in the extracranial cerebrovascular system is the
Origin of the CCA Origin of the ICA Distal ICA Proximal ECA
Duplex sonographic criteria to diagnose a total CCA occlusion typically include all of the following except
An anechoic vessel lumen Absence of color Doppler filling Absence of a spectral Doppler signal Lack of radial pulsatility of the vessel
To document the absence of a spectral Doppler signal in an occluded CCA, machine settings should be made for all of the following except
Increased Doppler gain Decreased pulse repetition frequency Decreased sample volume size Increased probe transmit frequency
An occluded CCA is most frequently associated with
A disease-free contralateral CCA A widely patent ipsilateral ICA and ECA An occluded ipsilateral ICA A patent ICA with collateral filling via proximal ECA branches
To-and-fro flow in a proximal common carotid artery is usually characteristic of
Aortic stenosis More distal CCA occlusion Isolated ipsilateral ECA occlusion Severe contralateral CCA obstruction
Clinical outcomes for patients with a CCA occlusion are usually better when
The ipsilateral ICA is patent The ipsilateral ICA is occluded, preventing emboli The ipsilateral ECA is occluded The contralateral CCA is also occluded
Footnotes