Asymptomatic Narrowed Artery of Neck may Carry Reduced Stroke Risk
Severely narrowed neck arteries that are not currently causing any symptoms may have a lower risk of stroke in patients as per a study at the Kaiser Permanente, published in JAMA.
Carotid stenosis occurs due to deposition of plaque (fatty cholesterol deposits) in one or both of the large arteries on either side of the neck that carry blood to the brain, face, and head. Narrowing of this artery typically may cause symptoms and risk of stroke.
‘In asymptomatic patients with severe asymptomatic carotid stenosis who do not have surgery medical management alone may reduce stroke risk.’
“The question of how to best treat patients with narrowing of the carotid artery without symptoms has been a long-standing research priority. We decided to take a step back and to begin our study by asking how likely is it that these patients will actually have a stroke related to their severe stenosis. Our analyses showed that this risk is so low that it appears that, for most patients, surgery may not be necessary,” says Robert Chang, at the Kaiser Permanente Division of Research.
Stroke Risk and Carotid Stenosis
Overall, 133 strokes were diagnosed in 129 patients during the follow-up period. Moreover, it was found that the patients who did not have surgery (to treat the stenosis) had a 4.7% cumulative risk of having a stroke within 5 years of their carotid stenosis diagnosis.
“We suspected that we may find a low risk of 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.” “This head-to-head comparison of carotid surgery versus medical management in a clinical trial is what we need to help us determine the appropriate approach,” says the study’s senior author, Mai N. Nguyen-Huynh at the Kaiser Permanente Division of Research