Abstract
Purpose: Owing to improvements of recent medical treatment, whether carotid endarterectomy (CEA) is beneficial for patients with asymptomatic carotid stenosis still remains controversial. This study was designed to clarify the risk of ipsilateral ischemic stroke in Japanese patients with asymptomatic carotid stenosis. Method: We studied the risk of TIA, ischemic stroke, coronary artery disease and death in 105 patients (mean age 76.2 years; woman 16) with asymptomatic carotid stenosis of 50% or more recruited consecutively from Jan 2009 and given recent medical treatment. Patients with any previous symptoms of ipsilatral TIA or stroke were excluded. Results: During a mean follow up of 2.74 years, there were 7 TIAs (one ipsilateral, 6 other territory) and 9 ischemic strokes (3 ipsilateral, 6 other territory). Two patients underwent subsequent CEA or carotid artery stenting, 7 had coronary artery disease, and 4 died during the follow-up period. The average annual event rate of ipsilateral ischemic stroke was 0.64% (95% CI, 0.08 to 4.72). Conclusion: The risk of ipsilateral ischemic stroke on recent medial treatment was very low. Benefit from CEA might be small, and selection of patients for CEA should include an assessment of coronary artery disease and life expectancy.
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