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- Always be sure to examine a patient's carotid arteries for bruits when concerned about stroke and/or TIA. Bruits suggest the presence of stenosis.
- Dijk and colleagues found that patients with > 50% carotid artery stenosis are at high rsk for stroke and TIA.
- Bruits are best ascultated by using the bell of the stethoscope and asking the patient to briefly hold their breath while trying to hear the abnormality.
- The American Heart Association recommends that symptomatic stenosis of > 50% undergo carotid endarectomy (CEA) within 2 weeks. If CEA is contraindicated, stenting should be pursued. CEA for stenosis of 70% to 99% is typically recommended regardless of symptomatology.
References
- Dijk et al. "Carotid Stiffness indicates risk of ischemic stroke and TIA in patients with internal carotid artery stenosis." Stroke. 2004; 35: 2258-2262.