#january2020mccqe1
A 60-year-old male has had three episodes of transient left monocular blindness and right hemianaesthesia. There is a soft bruit in the neck on the left and Doppler studies show a 25% stenosis of the internal carotid artery at the bifurcation. What is the most appropriate next step in management?
(A) immediate carotid endarterectomy
(B) carotid endarterectomy after 2 months
(C) aspirin, 100 mg each day
(D) warfarin (INR 3.5-4.0)
(E) intracarotid streptokinase infusion
A 60-year-old male has had three episodes of transient left monocular blindness and right hemianaesthesia. There is a soft bruit in the neck on the left and Doppler studies show a 25% stenosis of the internal carotid artery at the bifurcation. What is the most appropriate next step in management?
(A) immediate carotid endarterectomy
(B) carotid endarterectomy after 2 months
(C) aspirin, 100 mg each day
(D) warfarin (INR 3.5-4.0)
(E) intracarotid streptokinase infusion
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