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December 2018; 8 (6) Commentary

Practice Current: How do you manage patients with a “hot carotid”?

Aravind Ganesh, John H. Wong, Bijoy K. Menon
First published November 21, 2018, DOI: https://doi.org/10.1212/CPJ.0000000000000562
Aravind Ganesh
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John H. Wong
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Bijoy K. Menon
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Luca Bartolini
Departments of Clinical Neurosciences (AG, JHW, BKM), Radiology (JHW, BKM), and Community Health Sciences (BKM) and the Hotchkiss Brain Institute (JHW, BKM), University of Calgary, Canada.
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Practice Current: How do you manage patients with a “hot carotid”?
Aravind Ganesh, John H. Wong, Bijoy K. Menon
Neurol Clin Pract Dec 2018, 8 (6) 527-536; DOI: 10.1212/CPJ.0000000000000562

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Abstract

Patients presenting with acutely symptomatic carotid stenosis (a “hot carotid”) are known to be at a high up-front risk of recurrent strokes. Uncertainties remain regarding the appropriate management of such patients in the acute period, particularly with respect to anti-thrombotic treatment as they await revascularisation with carotid endarterectomy (CEA) or angioplasty/stenting (CAS). Decision-making is further complicated when intraluminal thrombi are encountered on vessel imaging. Given these uncertainties, and the paucity of high-quality data in the literature, we sought expert opinion from around the globe on how to manage patients with a “hot carotid” as they await CEA/CAS, with a focus on anti-thrombotic treatment options. Similar questions were posed to the rest of our readership in an online survey, the results of which are also presented.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • Editorial, page 466

  • Explore this topic NPub.org/NCP/pc08

  • Interactive world map NPub.org/NCP/map08

  • More Practice Current NPub.org/NCP/practicecurrent

  • Received July 19, 2018.
  • Accepted September 11, 2018.
  • © 2018 American Academy of Neurology
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