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What’s the risk of stroke with untreated asymptomatic severe carotid stenosis?

Journal
JAMA
Reuters Health - 24/05/2022 - For patients with asymptomatic severe carotid stenosis who opt out of surgery, the risk of stroke hovers around 5% over five years, a new study suggests. How best to manage patients with asymptomatic severe carotid stenosis remains "uncertain, due to advances in medical care and a lack of contemporary data comparing medical and surgical treatment," Dr. Robert Chang of Kaiser Permanente Northern California (KPNC), in Oakland, and colleagues note in JAMA. They retrospectively evaluated stroke outcomes among patients with medically treated asymptomatic severe carotid stenosis who did not have surgery. The cohort included 3,737patients (4,230 unique arteries) with 70% to 99% asymptomatic carotid stenosis identified between 2008 and 2012 and followed up through 2019 as part of KPNC. Prior to any intervention, there were 133 ipsilateral strokes with an average annual stroke rate of 0.9% (95% CI, 0.7% to 1.2%). Over five years, t...


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