This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Durward, Q. J. Articles by Barr, H. W. Search for Related Content PubMed PubMed Citation Articles by Durward, Q. J. Articles by Barr, H. W.

Stroke, Vol 13, 459-464, Copyright © 1982 by American Heart Association

ARTICLES

The natural history of asymptomatic carotid bifurcation plaques

QJ Durward, GG Ferguson and HW Barr

Seventy-three patients with an angiographically identified asymptomatic stenosis (greater than 50%) and/or ulceration of the common carotid bifurcation have been followed from 6 months to 10 years (average 4 years). All patients had previously undergone contralateral carotid endarterectomy for a transient ischemic attack (TIA) or minor stroke in that carotid territory. During follow-up, 22 patients (30%) developed new symptoms of cerebral ischemia. Twelve developed ischemia referable to the previously asymptomatic side (10 TIA's, 2 strokes). Six developed recurrent ischemic symptoms in the territory of the previously symptomatic and operated carotid artery (2 TIA's, 4 strokes). Five developed ischemia in the vertebro-basilar territory (2 TIA's, 3 strokes). Thirteen patients (17%) died during follow-up, including 6 from cardiovascular disease and 3 from stroke. In our series the incidence of stroke in the territory of a significant asymptomatic carotid plaque was low (3%). Patients were as likely to develop stroke in the territory of a previously operated carotid artery (5%) with asymptomatic carotid lesions is to keep them under review and to consider endarterectomy only if appropriate ischemic symptoms (which are most likely to be TIA's) develop.

This article has been cited by other articles:

				D. J. Bertges, V. Muluk, J. Whittle, M. Kelley, D. S. MacPherson, and S. C. Muluk Relevance of Carotid Stenosis Progression as a Predictor of Ischemic Neurological Outcomes Arch Intern Med, October 27, 2003; 163(19): 2285 - 2289. [Abstract] [Full Text] [PDF]

				B. G. Eklof, R. L. Kistner, E. M. Masuda, and H. P. Wong Outcome of the Contralateral Carotid Artery in Patients Having Undergone Ipsilateral Carotid Endarterectomy: Results of Selective Management Vascular and Endovascular Surgery, May 1, 1998; 32(3): 221 - 232. [Abstract] [PDF]

				K. Kasirajan, G. Cornu-Labat, J. J. Turner, and J. R. Rubin Electron Microscopic Luminal Surface Characteristics of Carotid Plaques Vascular and Endovascular Surgery, November 1, 1997; 31(6): 769 - 774. [Abstract] [PDF]

				T. Mannami, M. Konishi, S. Baba, N. Nishi, and A. Terao Prevalence of Asymptomatic Carotid Atherosclerotic Lesions Detected by High-Resolution Ultrasonography and Its Relation to Cardiovascular Risk Factors in the General Population of a Japanese City : The Suita Study Stroke, March 1, 1997; 28(3): 518 - 525. [Abstract] [Full Text]

				M. D. Colburn and W. S. Moore Risk-Benefit Aspects of Surgery for Asymptomatic Carotid Artery Stenosis Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1994; 7(2): 6 - 30. [PDF]

				R. W. Hobson Asymptomatic Carotid Stenosis: Current Diagnosis and Management Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1988; 1(1): 141 - 154. [PDF]

				J. A. Murie, C. D. Sheldon, and R. O. Quin Symptoms and Signs of Carotid Territory Transient Cerebral Ischaemia Vascular and Endovascular Surgery, January 1, 1986; 20(1): 20 - 26. [Abstract] [PDF]