The grade of carotid stenosis as a prognostic factor during a 14 years' follow-up in 40 angiographically documented patients with cerebrovascular disease.
Forty consecutive patients underwent extracranial arteriography between 1974-1976 because of cerebrovascular disease and were treated nonoperatively. This period was chosen to ensure a sufficiently long follow-up. The treatment selection was made individually by the patient's doctor. Deaths (n = 22) during 14 years of follow-up were caused by cerebrovascular disease in 41%, by coronary heart disease in 27% and other in 32%. The median age of decreased patients (group A) was 60.5 years at the time of arteriography and of patients alive after follow-up (group B) 55.5 years, respectively (p = 0.007). Findings were more severe arteriographically in group A than in group B. Twelve patients had occlusion or > 50% stenosis in the common carotid artery or the internal carotid artery in group A and three in group B (p = 0.014). During follow-up there were 17/22 cerebrovascular events in group A and 8/18 in group B (p = 0.033). Smoking was significantly more common in group A (p = 0.002). When the patients were divided on the basis of haemodynamically significant carotid artery stenosis, patients with significant stenosis (group C) proved to be older than patients with non-significant stenosis (group D), 62.0 versus 57.0 years, respectively (p = 0.001). The incidence of cerebrovascular events was equal in these groups. Our data suggest that patients with over 50% carotid stenosis have a poor long term prognosis, associated with age and smoking.
Kuukasjärvi
P
P
Department of Surgery, University of Tampere, Finland.
Salenius
J P
JP
D000367:Age Factors; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000401:mortality*; D003327:Coronary Disease / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors