Carotid or vertebral artery stenosis
What the FAA's documents say about carotid or vertebral artery stenosis, in plain words, with the FAA's own words one press away.
FAA term: Carotid / Vertebral Artery Stenosis
Your step-by-step plan
Step 1: The progress note from the treating doctor or specialist
The note the examiner reviews, and what it finds.Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician or specialist, no more than 90 days before the exam. Your AME reviews it.
It finds
- The condition is stable, with no symptoms
- No clinically significant increase in stenosis that would prompt a change in treatment or surveillance
Show the FAA's words: The progress note from the treating doctor or specialist
the AME must review a current, detailed Clinical Progress Note generated from a clinic visit with the treating physician or specialist no more than 90 days prior to the AME exam.
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
A current, detailed Clinical Progress Note from the treating physician performed no more than 90 days prior to AME exam finds: [ ] Condition is stable with NO symptoms.
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
A current, detailed Clinical Progress Note from the treating physician performed no more than 90 days prior to AME exam finds:
AND [ ] There has been NO clinically significant increase in stenosis that would prompt a change in treatment or surveillance
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
Step 2: Imaging of both sides
The study, what it shows, and when it was performed.A carotid ultrasound, CT angiogram (CTA), magnetic resonance angiography (MRA) or angiogram, performed within the previous one year.
It shows
- 79% or less on both sides (right and left)
Show the FAA's words: Imaging of both sides
Imaging Carotid ultrasound, CT Angiogram (CTA), Magnetic resonance angiography (MRA), or angiogram [ ] 79% or less on both sides (right and left) AND [ ] performed within the previous ONE YEAR
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
Step 3: The cause
The causes the worksheet accepts, and what is not CACI.One question insideThe worksheet's causes: carotid or vertebral artery stenosis, or its surveillance 2 or more years after surgery to correct it.
The cause
- Carotid or vertebral artery stenosis
After surgery to correct the stenosis
- Surveillance 2 or more years after the surgery (carotid endarterectomy, stent, etc.)
Not CACI
- Not: A history of stroke or TIA
Show the FAA's words: The cause
Causes [ ] Carotid / Vertebral Artery Stenosis OR [ ] Carotid / Vertebral Artery Stenosis surveillance 2 or more years AFTER surgery to correct stenosis (carotid endarterectomy, stent, etc.)
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
NOTE: History of stroke or TIA, are not CACI. See corresponding page.
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
Step 4: The worksheet's criteria
Your medications for the condition.Medications for the condition from the worksheet's list, in any combination.
The worksheet's list
- None
- ASA (aspirin)
- Plavix or Brilinta (ASA allowed in combination)
Do not qualify for CACI
- Not: DOAC/NOAC/coumadin
Show the FAA's words: The worksheet's criteria
Medications for condition (any combination of the following) [ ] None [ ] ASA (aspirin) [ ] Plavix or Brilinta (ASA allowed in combination) Note: DOAC/NOAC/coumadin do not qualify for CACI, see Special Issuance guidelines, row C
FAA source: CACI – Carotid/Vertebral Artery Stenosis. FAA date 28 January 2026; checked by Crosscheck 14 October 2026.
At later exams
- First and second class
- Every year
- Third class
- At each required exam
The worksheet says first- and second-class applicants must provide this information every year, and third-class applicants must provide it with each required exam.
Show the FAA's words: how often the FAA asks again
Applicants for first- or second- class must provide this information annually; applicants for third-class must provide the information with each required exam.
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Surveillance two years after surgery
Where surgery was done to correct the stenosis (carotid endarterectomy, stent, etc.), the worksheet's causes line names surveillance 2 or more years after the surgery.
Show the FAA's words: good to know, 2
Causes [ ] Carotid / Vertebral Artery Stenosis OR [ ] Carotid / Vertebral Artery Stenosis surveillance 2 or more years AFTER surgery to correct stenosis (carotid endarterectomy, stent, etc.)
DOAC, NOAC and coumadin are not CACI
The worksheet notes that DOAC/NOAC/coumadin are not accepted for CACI, and sends the examiner to the Special Issuance guidelines, row C.
Show the FAA's words: good to know, 3
Note: DOAC/NOAC/coumadin do not qualify for CACI, see Special Issuance guidelines, row C
Three statements for Block 60
The examiner must note one of three in Block 60: CACI qualified carotid/vertebral artery stenosis, where documents need not go to the FAA; has current or previous SI/AASI but now CACI qualified; or NOT CACI qualified, deferred, with supporting documents submitted.
Show the FAA's words: good to know, 4
AME MUST NOTE in Block 60 one of the following: … CACI qualified Carotid/Vertebral Artery Stenosis. (Documents do not need to be submitted to the FAA.) … Has current OR previous SI/AASI but now CACI qualified Carotid /Vertebral Artery Stenosis. … NOT CACI qualified Carotid/Vertebral Artery Stenosis. I have deferred. (Submit supporting documents.)
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.