Natural history of patients with unoperated atherosclerotic carotid artery disease--results from a retrospective study.
The natural history of carotid artery disease was studied in a retrospective study of 609 angiograms performed during 1969-1979 on patients who had subsequently not been operated on. The indication for angiography differed, but was aimed at clarifying suspected cerebrovascular events. 578 patients could be followed-up after a median time of 10.4 years (0-22). The median survival time after angiography was 9.7 years for the 355 men and 12.8 years for the 223 women (p = 0.0099). Internal carotid stenosis of > 50% was seen in 9.0% (bilaterally in 2.2%), a stenosis > 75% in 4.5% (bilaterally in 0.9%) and occlusion in 9% (bilaterally in 0.7%). Ulceration was present in 10.7% (bilaterally in 1.6%). 26.5% of the patients had a cerebrovascular event during follow-up, of which 31.4% had transient ischaemic attack or amaurosis fugax. Survival was not influenced by the degree of stenosis, but presence of arteriosclerotic carotid artery disease significantly reduced the median survival time from 11 to 3 years. The main cause of death for men was myocardial infarction (27.7%) and for women a cerebrovascular event (27.8%), a significant difference. From this study, in selected patients it can be concluded that the annual frequency of cerebrovascular events was low, approaching frequencies reported in asymptomatic patients. The cause of death differed between men and women, with more cardiac deaths among men and more cerebrovascular deaths among women.
Mätzsch
T
T
Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Bergqvist
D
D
Lindh
M
M
Maly
P
P
Takolander
R
R
D002340:Carotid Artery Diseases / Q000401:mortality* / Q000601:surgery; D016893:Carotid Stenosis / Q000401:mortality / Q000601:surgery; D002423:Cause of Death; D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000401:mortality* / Q000601:surgery; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis