Low Risk of Stroke From Progression to Carotid Occlusion
(HealthDay News) — For patients with asymptomatic carotid stenosis, the risk of stroke from progression to carotid occlusion is low, according to research published online Sept. 21 in JAMA Neurology.
Catherine Yang, from McMaster University in Hamilton, Canada, and colleagues examined the risk of stroke resulting from progression to occlusion among patients with asymptomatic carotid stenosis. They conducted a retrospective analysis of data obtained from 3,681 patients identified from 1990 through 2012.
The researchers found that 8.6 percent of patients with data on sequential annual carotid ultrasonography examination during the study period were asymptomatic before an index occlusion. Most new occlusions (80.4 percent) occurred before 2002, when medical therapy was less intensive, and there was a decrease in frequency by quartile of years. One patient had a stroke at the time of the occlusion (0.3 percent), and three had ipsilateral stoke during follow-up (0.9 percent); all occurred before 2005. At a mean follow-up of 2.56 years, neither severity of stenosis nor contralateral occlusion predicted the risk of ipsilateral stroke or transient ischemic attack, death from stroke, or death from unknown causes (P = 0.80 and 0.73, respectively). The risk of these events was significantly predicted by age, sex, and carotid burden.
"The risk of progression to carotid occlusion is well below the risk of carotid stenting or endarterectomy and has decreased markedly with more intensive medical therapy," the authors write.