engleski

Prospective follow-up of patients with moderate carotid stenosis

Background: Patients with moderate carotid stenosis are not considered to be in the high risk stroke group and their usual treatment is conservative. The aim of this study was to follow up patients with moderate carotid stenosis during 5 years period. Patients and methods: Among 1284 stroke patients hospitalized in 1999 ; 78 (6 %) patients (48 men, mean age 68, 30 women, mean age 74) had moderate carotid artery stenosis (50-70 %) of at least 1 artery, and 20 % had bilateral moderate stenosis or occlusion of the other artery. A total of 58 patients completed the study ; 10 patients were lost during follow-up and 10 patients died early during hospitalization. Results: In 1999 year, 62 (79 %) patients had stroke – 39 (50 %) men, 22 (29 %) women, TIA had 15 (19 %) patients - 8 (10%) men and 7 (9 %) women, 2 (3%) of patients had subarachnoid hemorrhage. Mortality in 1999 was 13 %. First ever stroke had 39 (50 %) patients of whom 41% had stroke ipsilateral to moderate carotid stenosis and 22 (28 %) patients had recurrent stroke. The most common risk factor was hypertension (91 %), while other risk factors were present in the range of 35– 40 %. Atrial fibrillation was present in 17 % of patients. Symptomatic stenosis was present in 59 %, asymptomatic in 11%, and ipsilateral amaurosis fugax was present in 31 % of patients. At the end of follow up period mortality was 38 %. Recurrent stroke ipsilateral to carotid stenosis occurred in 39 % of patients and TIA in 18 %, stroke in 2 % and TIA in 2% of others. Carotid endarterectomy during follow up was performed in 50 % of patients, of whom 12 % had stroke. Conclusions: Moderate carotid stenosis in older age groups, especially in men may represent a higher risk factor for stroke than previously believed.

carotid stenosis; follow up; ultrasound

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