当前位置： SCI文献检索 > JOURNAL OF VASCULAR SURGERY期刊下所有文献 > Outcome of moderate carotid artery stenosis in patients who are asymptomatic.

Outcome of moderate carotid artery stenosis in patients who are asymptomatic.

Abstract：

PURPOSE:The incidence rate of disease progression and stroke after the diagnosis of a moderate (50% to 79%) carotid stenosis was determined by means of color-flow duplex scanning. METHODS:During a 4-year period, 344 male veterans with moderate internal carotid artery stenoses, on one or both sides, were examined at regular intervals for a mean period of 25 months. Carotid color-flow scans were obtained semiannually. Clinical follow-up was performed to determine the incidence rate of amaurosis fugax, transient ischemic attacks, nonhemispheric symptoms, and strokes. RESULTS:New neurologic symptoms developed in 75 patients (21.8%). Fifty-one (14.8%) had ipsilateral symptoms during follow-up: 18 amaurosis fugax (5.2%), 14 transient ischemic attacks (4%), 5 nonhemispheric symptoms (1.4%), and 14 strokes (4%). Twenty-four patients (6.9%) had contralateral symptoms: 20 strokes (5.8%) and 4 transient ischemic attacks (1.2%). Life-table analysis showed that the annual rate of ipsilateral neurologic events was 8.1%, and the annual rate of stroke was 2.1%. Seventy-five patients (22%) died in the follow-up period. Disease progression to 80% to 99% stenosis or occlusion occurred in 71 of 458 vessels (15.5%). The internal carotid arteries that showed evidence of disease progression had a significantly higher initial peak systolic velocity (251 vs 190 cm/s; P <.0001) and end diastolic velocity (74 vs 52 cm/s; P < 0.0001). Black patients and patients with ischemic heart disease were at a higher risk for disease progression. We could not identify any atherosclerotic risk factors that reliably predicted patients in whom future ipsilateral neurologic symptoms were more likely to develop. However, there was an increased risk of stroke associated with progression of disease. CONCLUSION:Patients who are asymptomatic and who have moderate carotid stenoses are at significant risk for neurologic symptoms and death, but have a relatively low incidence rate of ipsilateral events. The initial flow characteristics in the stenotic vessel are predictive of future disease progression, but they are not helpful in identifying patients in whom symptoms will develop.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Mansour MA,Littooy FN,Watson WC,Blumofe KA,Heilizer TJ,Steffen GF,Chmura C,Kang SS,Labropoulos N,Greisler HP,Fisher SG,Baker WH

doi

10.1016/s0741-5214(99)70375-7

subject

Has Abstract

pub_date

1999-02-01 00:00:00

pages

217-25; discussion 225-7

issue

eissn

0741-5214

issn

1097-6809

pii

S0741521499000439

journal_volume

pub_type

杂志文章

在线工具

Outcome of moderate carotid artery stenosis in patients who are asymptomatic.