Outcome of asymptomatic cervical bruits in a veteran population.
The potential risk of stroke in patients with a localized asymptomatic cervical bruit continues to be a source of debate. We identified 273 patients with 374 asymptomatic mid-cervical bruits. Using Doppler with spectral analysis, the internal carotid artery (ICA) was stratified into one of three groups; greater than or less than 75% cross section area stenosis, or occlusion. Each carotid artery was evaluated for progression of stenosis and occurrence of neurologic events (TIA's and strokes). During an average follow-up of 29.6 months, 26 neurologic events (10 strokes, 16 TIA's) occurred ipsilateral to the carotid bruits. Most asymptomatic bruits (308/374; 82%) were associated with carotid arteries having less than 75% stenosis and the risk of stroke from those arteries remaining at less than 75% stenosis (254/308) was 1.5%. However, progression to greater than 75% stenosis or occlusion as determined at the most recent noninvasive examination (54/308) was associated with a significant risk for stroke (7.4%; p less than 0.001). Progression to occlusion in the total population was highly significant for the risk of developing stroke (4 out of 19; p less than 0.001).
Department of Surgery, University of Kentucky, Lexington.
E D
ED
Endean
G
G
Steffen
C
C
Chmura
S R
SR
Gupta
F N
FN
Littooy
D000368:Aged; D001314:Auscultation; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014728:Veterans