Asymptomatic carotid stenosis has low stroke risk, may not require surgery: JAMA

OAKLAND, Calif: The risk of having a future stroke caused by a severe blockage in an artery in the neck that is not currently causing any symptoms is so low that most patients with this condition-asymptomatic carotid stenosis-could potentially be treated with the newest medications and may not require surgery, new Kaiser Permanente research suggests.

"The question of how to best treat patients with narrowing of the carotid artery without symptoms has been a long-standing research priority," said Robert Chang, MD, a physician researcher at the Kaiser Permanente Division of Research and a vascular surgeon with The Permanente Medical Group. "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."

The study, published May 24 in JAMA, is believed to be the largest and most current assessment of long-term stroke risk in this population.

Carotid stenosis occurs when plaque-fatty cholesterol deposits-builds up in one or both of the large arteries on either side of the neck that carry blood to the brain, face, and head. This narrowing in the artery is typically diagnosed after a patient has experienced symptoms of a stroke, but it can also be found during a routine physical examination.