Carotid Stenosis Calculator - Interactive Decision Tool

Carotid Artery Stenosis Decision Tool

Carotid artery stenosis interactive management calculator.

1. Symptoms: Ipsilateral stroke, TIA, or monocular vision loss within the last 6 months?

Yes (symptomatic) No (asymptomatic / remote)

Canadian Stroke Best Practice Recommendations (CSBPR) defines symptomatic as an ipsilateral cerebral or retinal ischemic event within the prior 6 months.

2. Days since the qualifying event (enter whole days)

If symptomatic, days must be ≤183 (≤6 months). Values beyond 183 days should be considered asymptomatic / remote.

3. Percent ipsilateral internal carotid artery stenosis (NASCET or reported percent)

Enter percent (0–100). If heavily calcified, confirm with CTA/MRA before revascularization decisions.

Heavily calcified plaque or other features making stenosis quantification unreliable?

If checked and your initial imaging is CTA/MRA, CSBPR notes ultrasound may be required to aid quantification (Evidence Level C).

4. Biological sex

Male Female

5. Life expectancy > 5 years?

Yes No

6. Fit for surgery / operative candidate?

Yes No

7. Surgeon/centre peri-op stroke/death risk ≤3%?

Yes No / unknown

8. High bleeding risk (recent major bleed, active GI bleed, or other)?

Yes No

9. Has CTA or contrast-enhanced MRA been performed to confirm stenosis (if revascularization being considered)?

Yes (CTA/MRA done) No (based on ultrasound only) Not applicable / not considering revascularization

CSBPR: confirm with CTA/MRA when revascularization considered (Level C). Conversely, ultrasound may be needed after CTA/MRA if heavy calcification prevents reliable quantification (Level C).

Recommendation

CSBPR-aligned

Medical management (applies to all patients)

Disclaimer: This tool provides guideline-aligned suggestions for clinical decision support only and does not replace clinical judgment nor specialist consultation.