| Identifier |
Carotid_Artery_and_Amaurosis_Lee |
| Title |
Carotid Artery and Amaurosis |
| Creator |
Andrew G. Lee, MD; Elijah Li |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (EL) Class of 2023, Baylor College of Medicine, Houston, Texas |
| Subject |
Amaurosis Fugax; Carotid Artery; TIA; Vision Loss |
| Description |
Dr. Lee lectures medical students on amaurosis. |
| Transcript |
"I want to talk to you about how we need to know a little bit about the carotid artery when we're looking in patients who have amaurosis fugax. That's a transient vision loss and for this carotid disease, it's going to be an ipsilateral, unilateral loss of vision. Or if you have a patient who has central retinal artery occlusion or a branch retinal artery occlusion or an ophthalmic artery occlusion, all of these can be embolic from the carotid artery. And typically, when we're doing workups for amaurosis fugax from TIA for the carotid, we're going to be doing a carotid doppler and or imaging of the neck CT/CTA or MRI/MRA of the neck. And the thing we're usually looking for is hemodynamically significant carotid stenosis. So that's normally recorded on the doppler as a percentage like 60 or 70 and 70 is kind of the cutoff that we use for determining whether we should have carotid endarterectomy or a carotid stent, although you could argue about doing 60 percent. The risk benefit ratio is going the opposite direction once you start getting the numbers below 60 it's more dangerous to do a surgery than it is to just follow the patient or treat the patient with aspirin therapy alone. The reason it's important is the morphology of the plaque has changed the way we approach some of these patients so they're presenting the same way to ophthalmology - hemispheric TIA, amaurosis fugax event an embolic CRO, BRAO, or an ophthalmic artery occlusion, but instead of just looking at the hemodynamically significant level of stenosis, we're looking at the plaque morphology. So, here's the plaque, and because we can image through the plaque we can see if there's an intraplaque hemorrhage. And we can also see on the imaging study whether the morphology of the plaque is not smooth. Those kinds of ugly morphologies regardless of level of stenosis might still be amenable to a stenting procedure or interventional procedure because this plaque is unstable and can fly off and cause a stroke. So, you need to know about both the level of hemodynamically significant stenosis and a little bit of a morphology as well as the determination for the marker that something's not right about this plaque and is dangerous about this plaque which is an intraplaque hemorrhage." |
| Date |
2022-03 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6jy2dna |
| Setname |
ehsl_novel_lee |
| ID |
1751070 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6jy2dna |
