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Carotid Artery Stenting (CAS) Questions and Answers 2025, Exams of Nursing

Chamberlain College of NursingNursing

Carotid Artery Stenting (CAS) Questions and Answers 2025

Typology: Exams

2025/2026

Available from 02/25/2026

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Carotid Artery Stenting (CAS) Questions and
Answers 2025
IndicationsAforAcarotidAarteryAstentingA(CAS)A-ACORRECTAANSWERSA-
RatherAthanAimprovingAflowAacrossAstenoticAlesions,ACASAaddressesAtheAmorbidityA
AssociatedAwithAocclusiveAdiseaseAbyAstabilizingAplaquesAproneAtoAembolizationAinAtheA
cerebralAcirculation.
PatientsAwithAcertainAmedicalAandAanatomicalAfactorsAareAhigh-
riskAsurgicalAcandidatesAwhoAmayAbeAbetterAsuitedAforACASAthanAcarotidAendarterectomyA(
CEA).
PatientsAmeetingAcertainAhigh-
riskAmedicalAandAanatomicAcriteriaAareAindicatedAforAtransfemoralAcarotidAarteryAstentingA(
TFCAS)AandAtranscarotidArevascularizationA(TCAR).AListAmedicalAriskAfactors:A-
ACORRECTAANSWERSA-
AgeA75AyearsAorAolderA(Note:AWhileAageA≥75AyearsAisAaAhighAriskAfactorAforATCAR,AolderAp
atientsAundergoingATFCASAhadAaAhigherAriskAofAstrokeAlikelyAdueAtoAaorticAarchAdiseaseAa
ndAlesionsAcrossingAwithAembolicAprotectionAdevices.)
CongestiveAheartAfailure
LeftAventricularAejectionAfractionA35%AorAless
UnstableAangina
AbnormalAstressAtest
NeedAforAmajorAsurgery,AincludingAopenAheartAorAvascularAsurgery
UncontrolledAdiabetes
SevereApulmonaryAdisease
AnatomicAhigh-riskAfactorsAforATFCASAandATCARAinclude:A-ACORRECTAANSWERSA-
ContralateralAcarotidAocclusion
TandemAstenosesAgreaterAthanA70%
HighAcervicalAcarotidAarteryAstenosis
RestenosisAafterAcarotidAendarterectomy
BilateralAcarotidAdiseaseArequiringAtreatment
HostileAneckA(priorAhead/neckAsurgeryAorAirradiation)
LaryngectomyAorAlaryngealApalsy
PermanentAcontralateralAcranialAnerveAinjury
SpinalAimmobility
AbsoluteAcontraindicationAtoACASA-ACORRECTAANSWERSA-
VisibleAthrombusAwithinAtheAlesion
InabilityAtoAgainAvascularAaccess
ActiveAinfection
SpontaneousAintracranialAhemorrhageAorArecentAstrokeAofAsufficientAsizeAforAhemorrhagicA
conversion
EvolvingAstroke,AtransientAischemicAattackA(TIA),AorAamaurosisAfugaxAwithinA48Ahours
pf3

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Carotid Artery Stenting (CAS) Questions and

Answers 2025

IndicationsAforAcarotidAarteryAstentingA(CAS)A-ACORRECTAANSWERSA- RatherAthanAimprovingAflowAacrossAstenoticAlesions,ACASAaddressesAtheAmorbidityA AssociatedAwithAocclusiveAdiseaseAbyAstabilizingAplaquesAproneAtoAembolizationAinAtheA cerebralAcirculation. PatientsAwithAcertainAmedicalAandAanatomicalAfactorsAareAhigh- riskAsurgicalAcandidatesAwhoAmayAbeAbetterAsuitedAforACASAthanAcarotidAendarterectomyA( CEA). PatientsAmeetingAcertainAhigh- riskAmedicalAandAanatomicAcriteriaAareAindicatedAforAtransfemoralAcarotidAarteryAstentingA( TFCAS)AandAtranscarotidArevascularizationA(TCAR).AListAmedicalAriskAfactors:A- ACORRECTAANSWERSA- AgeA 75 AyearsAorAolderA(Note:AWhileAageA≥75AyearsAisAaAhighAriskAfactorAforATCAR,AolderAp atientsAundergoingATFCASAhadAaAhigherAriskAofAstrokeAlikelyAdueAtoAaorticAarchAdiseaseAa ndAlesionsAcrossingAwithAembolicAprotectionAdevices.) CongestiveAheartAfailure LeftAventricularAejectionAfractionA35%AorAless UnstableAangina AbnormalAstressAtest NeedAforAmajorAsurgery,AincludingAopenAheartAorAvascularAsurgery UncontrolledAdiabetes SevereApulmonaryAdisease AnatomicAhigh-riskAfactorsAforATFCASAandATCARAinclude:A-ACORRECTAANSWERSA- ContralateralAcarotidAocclusion TandemAstenosesAgreaterAthanA70% HighAcervicalAcarotidAarteryAstenosis RestenosisAafterAcarotidAendarterectomy BilateralAcarotidAdiseaseArequiringAtreatment HostileAneckA(priorAhead/neckAsurgeryAorAirradiation) LaryngectomyAorAlaryngealApalsy PermanentAcontralateralAcranialAnerveAinjury SpinalAimmobility AbsoluteAcontraindicationAtoACASA-ACORRECTAANSWERSA- VisibleAthrombusAwithinAtheAlesion InabilityAtoAgainAvascularAaccess ActiveAinfection SpontaneousAintracranialAhemorrhageAorArecentAstrokeAofAsufficientAsizeAforAhemorrhagicA conversion EvolvingAstroke,AtransientAischemicAattackA(TIA),AorAamaurosisAfugaxAwithinA 48 Ahours

RelativeAcontraindicationsAtoACASA-ACORRECTAANSWERSA- AAheavilyAcalcified/diseasedAaorticAarchAorAtypeAIIIAaorticAarchA(discussedAfurtherAbelowAa ndApertinentAtoATFCASAonly) InabilityAtoAdeployAcerebralAprotectionAdeviceAorAutilizeAflowAreversal SeverelyAtortuousAcarotidAarteries NearAocclusionAorA"stringAsign"AgreaterAthanA 1 AcmAofAtheAoperativeAcarotidAartery IdealATFCASAanatomyA-ACORRECTAANSWERSA- TheAcommonAfemoralAarteryAwillAbeAreasonablyAfreeAofAcalcification,AandAtheAsubsequentA pathAtoAtheAcarotidAarteryAofAinterestAmustAbeAwithoutAobstruction. TCARAguidelinesA-ACORRECTAANSWERSA- theAcommonAcarotidAarteryAmustAbeAatAleastA 6 AmmAinAdiameterAandA 5 AcmAinAlengthAfromAth eAclavicleAtoAtheAbifurcationAwithAanAinternalAcarotidAarteryAmeasuringA 4 AtoA 9 Amm RelevantAonlyAtoATFCAS,AtheAaorticAarchAcanAbeAclassifiedAintoAthreeAtypesAbasedAonAtheA relationshipAofAtheAplaneAperpendicularAtoAtheAoriginAofAtheAbrachiocephalicAarteryAtoAtheAp laneAperpendicularAtoAtheAouterAcurvatureAofAtheAarch.A-ACORRECTAANSWERSA- InAtypesAIAandAII,AtheAdistanceAbetweenAtheseAtwoAplanesAisAlessAthanAtwoAtimesAtheAdiam eterAofAtheAcommonAcarotidAartery. InAtypeAIII,AtheAdistanceAbetweenAtheseAtwoAplanesAexceedsAtwoAtimesAtheAdiameterAofAth eAcommonAcarotidAartery,ArenderingAwireAandAcatheterAaccessAtoAthisAvesselAchallengingA becauseAofAtheAlocationAofAtheAoriginAofAtheAvesselAasAwellAasAtheAharshAacuteAangleAintro ducedAintoAtheAcatheterAsystemAbyAcannulatingAtheAorigin. MedicalAtherapyAbeforeAandAafterATFCASAandATCARA-ACORRECTAANSWERSA- ForAbothATFCASAandATCAR,AdualAantiplateletAtherapyAinAtheAformAofAaspirinAandAclopidog relA(orAanAalternativeAantiplateletAagent)AshouldAbeAinstitutedAatAleastA 5 AdaysAbeforeAtheApr ocedureAandAcontinuedAatAleastA 30 AdaysAafterAtheAprocedure. MostAcommonApostopAcomplicationAinACAS,AevenAthoughAitsAlessAthanACEAA- ACORRECTAANSWERSA-myocardialAinfarctionAinA 1 - 4%AofAptsAafterAprocedure StrokeAisAoneAofAtheAmostAfearedApostoperativeAcomplicationsAofAanyAcerebrovascularApro cedure;ApostoperativeAstrokeAratesAdifferAbetweenATFCASAandATCARAapproaches. WhatAtoAdoAinAthisAcase?A-ACORRECTAANSWERSA- TheseApatientsAshouldAbeAsupportedAwithAaAvasopressorA(preferablyAphenylephrine)AuntilA theAunderlyingAautonomicAdysregulationAspontaneouslyAresolves. ForAmostApatients,AhypotensionAresolvesAwithinA 8 AtoA 10 AhoursAbutAmayAendureAupAtoA 24 Ah oursAorAmore. ProlongedAhypotensionAisAmoreAlikelyAtoAbeAseenAinAolderApatients,AthoseAwithAaAlesionAm oreAthanA 10 AmmAfromAtheAcarotidAbifurcation,AandAthoseAwhoAexperiencedAaArecentAstroke . anotherAcomplicationAespAafterAcontrastA-ACORRECTAANSWERSA-renalAinsufficiency whichApatientsAareAcandidatesAforAreintervention?A-ACORRECTAANSWERSA-High- gradeArestenosisAofAtheAstentA(>75%)AisAdefinedAbyAaApeakAsystolicAvelocityA(PSV)AofAgrea terAthanA 300 AcmAperAsecondAandAanAend- diastolicAvelocityA(EDV)AofAgreaterAthanA 90 AcmAperAsecondAwithAaAPSVAratioAhigherAthanA 4 .