Stroke Risk Low for Non-Surgically Treated Asymptomatic Carotid Stenosis

WEDNESDAY, June 1, 2022 (HealthDay News) -- Among patients with asymptomatic severe carotid stenosis who did not undergo surgical intervention, the estimated rate of ipsilateral carotid-related acute ischemic stroke is 4.7 percent over five years, according to a study published in the May 24/31 issue of the Journal of the American Medical Association.

Robert W. Chang, M.D., from Kaiser Permanente Northern California in San Francisco, and colleagues estimated stroke outcomes among patients with medically treated asymptomatic severe carotid stenosis who did not undergo surgical intervention. The analysis included 3,737 adults with asymptomatic severe (70 to 99 percent) carotid stenosis diagnosed between 2008 and 2012 with follow-up through 2019.

The researchers report that among the eligible patients, 2,539 arteries in 2,314 patients never received intervention. During a mean follow-up of 4.1 years, prior to any intervention, there were 133 ipsilateral strokes, with a mean annual stroke rate of 0.9 percent. By five years, the estimate of ipsilateral stroke was 4.7 percent.

"We suspected that we may find a low risk of stroke in these patients because there are now better stroke-prevention treatments, including medications to control blood pressure, prevent blood clots, and reduce cholesterol, than when the original randomized trials were done," a coauthor said in a statement. "I think our study will make many patients and their doctors think twice about surgery if they can instead be on an effective aggressive medical management program to lower their stroke risk from asymptomatic carotid disease."

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