Do you consider a severe ICA stenosis (70-99% narrowing per NASCET criteria) symptomatic if a lacunar stroke attributable to small vessel disease occurs in the perforating arteries (e.g. lenticulostriate) downstream from the stenosis?

Do you offer this person a vascular intervention (i.e., CEA or stenting)?

Answer from: at Community Practice

This is a great question and I do not think there’s a definite answer for it. Indeed a small portion of subcortical lacunar infarcts is due to proximal embolism. On the other hand, lacunar infarcts and ECAD share multiple risk factors. Evidence of prior embolic-looking lesions, carotid plaque ...

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at Neurology Specialists of Greater Pittsburgh
Thank you.

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Do you consider a severe ICA stenosis (70-99% narrowing per NASCET criteria) symptomatic if a lacunar stroke attributable to small vessel disease occurs in the perforating arteries (e.g. lenticulostriate) downstream from the stenosis?

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