M.A.S
Forum Senior
Topics: 28
Posts: 56
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Carotid endarterectomy is indicated if:
a. stenosis > 70%
b. symptomatic
c. stenosis > 70% and symptomatic
please explain your point of view..
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| tess
Forum Guru
Topics: 131
Posts: 368
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a, u see symtomatic condition is sure an indication; and research see the pt with stenosis > 70% are in soon danger for stroke, so it is an indication also. Any more addition is welcome. 
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| M.A.S
Forum Senior
Topics: 28
Posts: 56
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is the ASYmptomatic stenosis of > 70% a clear indication?
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| Ouli Maty
Forum Elite
Topics: 33
Posts: 275
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I don't thing so. It has to be 75% assympt .
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| medic
Forum Newbie
Topics: 6
Posts: 10
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:arrow: From a surgical point of view, a stenosis>70% is to cause CVA sooner or later, with/without symptoms.
On the other hand, End aretrectomy is not that dangerous operation...As a prof. says...
So I'm convinced that the answer is a..
PLEASE CORRECT ME...
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| destiny
Forum Senior
Topics: 35
Posts: 38
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in germany even 60% shows indication.
thanks
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| bobby
Forum Guru
Topics: 136
Posts: 569
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from boards and wards;
stenosis is 70 % occluded and pt has symtoms :arrow: endarterectomy
so C should be right!
but i think all your answers are correct, depending on the expertise of the sergeon.
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| Healer4life
Forum Newbie
Topics: 4
Posts: 20
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Hello,
What wound up being the right answer? A or C?
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| bozhenka
Forum Senior
Topics: 1
Posts: 122
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Symtomatic patients with a 50%-99% stenosis in the ipsilateral carotid artery have a beneficial effect from carotid endarterectomy. The 2-year risk of an ipsilateral stroke is 9% in symptomatic patients with a high-grade stenosis treated with surgery and aspirin. Similar patients treated non-surgically with aspirin alone have a 26% chance of having an ipsilateral stroke.
Asymtomatic patients with a 60-99% stenosis may also benefit from carotid repair. An asymtomatic, high-grade carotid stenosis is associated with a stroke rate of approximately 10.6% over 5 years. If the surgery is performed with an operative morbidity and mortality of <3%, the 5-year risk of stroke can be reduced to 4.8%.
So, correct answer is A.
And one more thing that we need to know on exam - most common complication of carotid endarterectomy is miocardial infarction.
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| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
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No symptom 70% stenosis is an indication.
and MI is definetely a MCC of the procedure.
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| Healer4life
Forum Newbie
Topics: 4
Posts: 20
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Thank you!!
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| dpk
Forum Junior
Topics: 10
Posts: 66
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this is wht i thought is the answer and to confirm myself i have kaplan notes of surgery in my hand right now so this is wht it says..
"carotid end. is indicated if the lesions found in the location that explains neurologic symptoms" with >70% stenosis...
so answer should be c...
good luck
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| dimps
Forum Guru
Topics: 63
Posts: 446
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M.A.S can u tell us the correct answer
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| M.A.S
Forum Senior
Topics: 28
Posts: 56
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Sorry, I'm also confused about this procedure, it wasn't a question in a books. In our country, surgeons says that a stenosis of more than 50-60% is an indication, but neurologists insist that it must be (>= 70%) + (symptomatic); considering the risk of surgery.
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| cache
Forum Guru
Topics: 130
Posts: 275
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I had a similar question , and the answer mentioned is Operating on a symptomatic stenosis of greater than 70% significantly reduces the incidence of stroke.
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| dimps
Forum Guru
Topics: 63
Posts: 446
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thanx cache
i also thought the same
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| dpk
Forum Junior
Topics: 10
Posts: 66
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thanks all of u..
good luck
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