How are cerebrovascular risk factors assessed during dermatologic preoperative evaluation and management?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

A careful history remains the best determinant of whether cerebrovascular disease poses a real or imagined risk to a patient who requires another operation. Patients who are at high risk, such as those with carotid bruits or cardiovascular disease, should undergo duplex ultrasonography of the carotid arteries before the operation to determine whether a significant stenosis (>70%) exists. If such lesions are found in patients who are symptomatic, endarterectomy should generally be considered before the other procedure. If the patient is asymptomatic with regard to the stenosis, then individual clinical judgment must be used to prioritize the sequence of operations.


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