Among patients with asymptomatic severe carotid stenosis who did not undergo surgical intervention, the estimated rate of ipsilateral carotid-related acute ischemic stroke is 4.7% over 5 years, according to a study published in the Journal of the American Medical Association. Robert W. Chang, MD, and colleagues estimated stroke outcomes among patients with medically treated asymptomatic severe carotid stenosis who did not undergo surgical intervention. The analysis included 3,737 adults with asymptomatic severe (70%-99%) carotid stenosis. Among the eligible patients, 2,539 arteries in 2,314 patients never received intervention. During a mean follow-up of 4.1 years, prior to any intervention, 133 ipsilateral strokes occurred, with a mean annual stroke rate of 0.9%. “We suspected that we may find a low risk for stroke in these patients because there are now better stroke-prevention treatments, including medications to control blood pressure, prevent blood clots, and reduce cholesterol, than when the original randomized trials were done,” a coauthor said in a statement.
