What is the role of preoperative imaging prior to CEA for atherosclerotic disease of the carotid artery?

Updated: Sep 29, 2021
  • Author: Jake F Hemingway, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Imaging studies should be performed preoperatively to determine the extent of stenosis, as well as to evaluate for kinks and coils that may affect the conduct of the operation (see Workup). Many surgeons who work with certified laboratories proceed with surgery on the basis of carotid duplex ultrasonography alone. If any doubt exists regarding the degree of stenosis or the distal extent of the disease, arteriography of the arch and the carotid is indicated.

The extent of the disease should also be noted, with particular attention to the superior extent of the stenosis. The superior disease extent may influence the type of anesthesia chosen, and additional measures may prove necessary to expose an unusually high lesion.

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