The natural history of asymptomatic carotid artery occlusive lesions.
The purpose of this retrospective study was to determine the long-term prognosis of patients with asymptomatic pressure-significant (hemodynamically significant) internal carotid system lesions. Of 640 neurologically asymptomatic patients, 292 had pressure-significant internal carotid artery occlusive lesions as determined by ocular pneumoplethysmography, while 348 had a carotid bruit only without a pressure-significant lesion. The annual stroke rate for the first three years on a Kaplan-Meier life-table basis was 3.4% and 1.5% in the abnormal and normal ocular pneumoplethysmography groups, respectively, as compared with a rate of 0.5% in a normal age- and sex-matched population. The annual total event rate (transient ischemic attack and stroke) was 5.2% in the abnormal vs 2.3% in the normal group, with 56% of all events ipsilateral to the ocular pneumoplethysmography abnormality. These results indicate that patients with asymptomatic pressure-significant carotid system occlusive lesions are at greater risk for stroke than a normal ocular pneumoplethysmography group (twofold) and a general population (sevenfold).
Meissner
I
I
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Wiebers
D O
DO
Whisnant
J P
JP
O'Fallon
W M
WM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000401:mortality; D001314:Auscultation; D002545:Brain Ischemia / Q000209:etiology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000401:mortality; D002343:Carotid Artery, Internal; D002544:Cerebral Infarction / Q000209:etiology; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies