Medical Management of Asymptomatic Severe Carotid Stenosis Has Improved Over the Years

Incidence of ischemic stroke has declined from about 2% to 1% annually.

Studies that informed managing patients with asymptomatic severe carotid stenosis (i.e., 70%–99%) were conducted longer than 20 years ago. Because medical management has changed markedly (and presumably improved) in recent decades, investigators determined the stroke incidence in ≈3700 medically managed patients (mean age, 74) with severe asymptomatic carotid stenosis diagnosed between 2008 and 2012 in a large community-based, integrated healthcare system. Patients were followed to 2019 or until death, stroke, or surgical intervention.

Incidence of ipsilateral ischemic stroke was 0.9% annually and 4.7% at 5 years. Strokes were more common in patients who were older, had high-grade stenosis (i.e., 90%–99%), or had previous contralateral strok…

Asymptomatic Carotid Artery Stenosis — Medical Management or Revascularization? 15:44

Reviewing Author

Thomas L. Schwenk, MD

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Thomas L. Schwenk, MD

Disclosures

Editorial BoardsUpToDate

Medical Management of Asymptomatic Severe Carotid Stenosis Has Improved Over the Years

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Reviewing Author