Clinical Case Database / Category: Case Based Discussion

Pharmacological management of carotid artery disease

Publication details

Miss Ammy Lam B.Pharm (Hons) PGDip, Mr Shiva Dindyal BSc MBBS MRCS, Mr Constantinos Kyriakides MB ChB MD FRCS
Foundation Years Journal, volume 2, issue 8, p.32 (123Doc Education, London, October 2008)

Abstract

A 66-year-old gentleman, with a past medical history of hypertension and hypercholesterolaemia (both of which were diet controlled), presented with a tingling sensation in his arms and blurred vision temporarily. A duplex scan showed 60% stenosis of his right carotid artery.

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Authors

Miss Ammy Lam B.Pharm (Hons) PGDip

Clinical Pharmacy Practice Pharmacist
Barts and The London NHS Trust
Directorate Pharmacist - General Surgery
London, UK

Mr Shiva Dindyal BSc MBBS MRCS (Corresponding author)

General Surgery Specialty Registrar/Vascular and Endovascular Research Fellow
Barts and The London NHS Trust
Circulatory Sciences Clinical Academic Unit
Vascular and Endovascular Surgical Services
The Royal London Hospital
London E1 1BB

Mr Constantinos Kyriakides MB ChB MD FRCS

Consultant Vascular and Endovascular Surgeon
Barts and The London NHS Trust
Circulatory Sciences Clinical Academic Unit
London, UK

References

1. NICE clinical guidance 68. Stroke: diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). National Institute for Health and Clinical Excellence. July 2008.
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3. Sobel M, Verhaeghe R. Antithrombotic therapy for peripheral artery occlusive disease: American College of Chest Physicians Evidence-Based Clinical Pratice Guidelines (8th edn). Chest, 2008, 133:815-843.
4. Gurm HS, Yadav JS, et al. Long-Term Results of Carotid Stenting versus endarterectomy in High-Risk Patients. N Engl J Med, 2008, 358:1572-1579.
5. Eckstein HH, Ringleb P, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. The Lancet Neurology, October 2008, 7(10):893-902.
6. Harrer JU, Morschel R, et al. High rate of restenosis after carotid artery stenting in patients with high-grade internal carotid artery stenosis: medium-term follow-up. J Neurol, September 2008:24.
7. Ong AT, Hoye A, et al. Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation. J Am Coll Cardiol, 2005, 45(6):947-953.
8. Bhatt DL, Kapadia SR, el al. Dual antiplatelet therapy with clopidogrel and aspirin after carotid artery stenting. Journal of Invasive Cardiology, 2001, 13:767-771.
9. Bajzer CT, Kapadia SR, et al. Clopidogrel use in carotid artery stenting. American Journal of Cardiology, 1999, 84(suppl6A); 7P(AbstractTCT-15th) 11th.[JC1]
10. Joint British Societies (JBS 2). Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart, 2005, 91(suppl5)V1-V52.
11. British Hypertension Society accessed via http://www.bhsoc.org/default.stm

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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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