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Review
. 2022 Dec;40(4):737-749.
doi: 10.1016/j.anclin.2022.08.015. Epub 2022 Oct 8.

The Unstable Carotid Plaque

Salim Habib  1 , Muhammad Saad Hafeez  1 , Theodore H Yuo  2 , Kathirvel Subramaniam  3
Affiliations
Review

The Unstable Carotid Plaque

Salim Habib et al. Anesthesiol Clin. 2022 Dec.

Abstract

Carotid revascularization is performed to prevent cerebrovascular events in patients with symptomatic (>50%) and asymptomatic high degree (>70%) carotid stenosis. As this operation carries significant risks for perioperative stroke, careful selection of patients who will benefit from the procedure is essential. Certain plaque characteristics, including texture, are associated with increased tendency for rupture and can be used to identify high-risk patients. Medical therapy, carotid endarterectomy, and carotid stenting are the mainstays for patient management. With careful selection of patients, all anesthesia techniques (general anesthesia, monitored anesthesia care, and regional anesthesia) can be used safely for these revascularization procedures.

Keywords: Anesthesia management; Cardiac and noncardiac surgery; Perioperative stroke; Unstable carotid plaque.

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