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vascular neurology stroke

Carotid Stenosis Assessment (NASCET/ECST)

Classifies carotid artery stenosis severity and guides endarterectomy vs stenting vs medical management based on NASCET criteria.

Score interpretation

Mild or asymptomatic moderate stenosis — medical management

→ Antiplatelet therapy (aspirin 75mg or clopidogrel 75mg); high-dose statin; BP and diabetes control; annual Duplex review

Moderate symptomatic or severe asymptomatic stenosis

→ Vascular surgery assessment; consider CEA in 50-69% symptomatic; CEA for 70-99% asymptomatic in selected patients; MDT decision

Severe symptomatic stenosis (70-99%) or recent TIA/stroke

→ Urgent CEA within 2 weeks of TIA/stroke if fit; carotid stenting (CAS) if CEA high risk; antiplatelet + statin immediately; same-day neurovascular/TIA clinic referral

Interpretation bands for the Carotid Stenosis. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.