Carotid stenosis associated with atrial fibrillation.
OBJECTIVE
To describe the prevalence and risk factors for carotid stenosis in TIA/stroke patients with non valvular atrial fibrillation (AF) and to compare clinical and CT characteristics of TIA/stroke in AF patients with and without carotid stenosis.


METHODS
50 TIA/stroke patients with AF who had ultrasound investigation of the extracranial vessels, included in a prospective hospitalar registry.


RESULTS
Twenty-two patients had some degree of carotid stenosis, but only 5 had more than 50% stenosis, including one with occlusion. Stenosis was neither more frequent nor more severe on the symptomatic side. Smokers were significantly more frequent in AF patients with > 50% stenosis. Clinical and CT features were quite similar in patients with and without carotid stenosis.


CONCLUSIONS
The association in a TIA/Stroke patient of AF and severe carotid stenosis on the symptomatic side is exceptional. TIA/strokes related to carotid stenosis cannot be identified by their clinical/CT characteristics. Management of these patients must be decided by stratification of risk of recurrence for AF and from carotid stenosis and balance of these risks with that of endarterectomy.
Ruivo
A
A
Serviço de Neurologia, Hospital de Santa Maria, Lisboa.
Lopes
M
M
Melo
T P
TP
Salgado
A V
AV
Oliveira
V
V
Canhão
P
P
Pinto
A N
AN
Crespo
M
M
Ferro
J M
JM
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D004691:Endarterectomy; D006321:Heart / Q000503:physiopathology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects