Mayo Clinic Neurologist Eugene L. Scharf, M.D ., Neuroradiologist E. Paul Lindell, M.D. , and Interventional Neuroradiologist Harry Cloft, M.D., Ph.D. , discuss the interdisciplinary collaboration with referring physicians when there is a diagnosis of carotid artery with stenosis.
"If there is any wish just for a second opinion, or a second set of eyes on a particular neurovascular question, that would be ample reason to refer," says Eugene Scharf, M.D.
Karatas hypnosis can be very deceptive and can fly under the radar when a carotid stenosis is discovered, it's critically important to stratify the risk of stroke. We have noninvasive vascular imaging that allows us to render a complete image of the carotid vascular circulation as well as the intracranial circulation. We can both look at the interior of the vessel how narrow it is and measure that. And there are a number of ways that we can then determine how severe that problem is. We are able to do basic examinations on everyone while we're doing those overwhelmingly. We're able to look at the examination and say, gosh, I see something here or I need to do that and we can modify the examination when it's being done. Typically, the patient doesn't have to come back for additional images if there's any diagnostic uncertainty or if there's any wish, just for a second opinion or a second set of eyes on a particular neurovascular question that would be ample reason to refer if there is ultimately a recommendation for a surgical or interventional carotid revascularization. I would think it'd be critically important in order to have a physician complete this that has a high volume. It's important to have a plan and a lot of the collaboration begins at the planning stage where physicians of different disciplines talk amongst ourselves about what should be the best approach before we even go on with an interventional procedure and we all work together behind the scenes to try to find out what the patient needs. We benefit from multiple different referral sources in that are revascularization and surgical specialists see these cases exclusively. It really is a group effort.
