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Recent experience with the asymptomatic cervical bruit.

M C Donaldson, C Sabine, A T Showah

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1987
    PubMed
    Summary
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    Asymptomatic cervical bruit patients had a 6.7% risk of stroke without surgery. Carotid endarterectomy in selected patients with severe carotid stenosis is a reasonable option with low morbidity.

    Area of Science:

    • Vascular Surgery
    • Neurology
    • Diagnostic Medicine

    Background:

    • Cervical bruit in asymptomatic patients is a clinical finding requiring evaluation.
    • Noninvasive vascular laboratory assessments are crucial for risk stratification.

    Purpose of the Study:

    • To evaluate the clinical outcomes of asymptomatic cervical bruit.
    • To determine the risk of neurologic events in patients with cervical bruit.
    • To assess the efficacy of carotid endarterectomy in selected patients.

    Main Methods:

    • Retrospective review of 418 patients referred for asymptomatic cervical bruit.
    • Follow-up of 370 patients for a mean of 23.7 months.
    • Analysis of neurologic events (transient ischemic attacks, stroke) and surgical outcomes.

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    Main Results:

    • 14 transient ischemic attacks and 7 strokes (6.7%) occurred in 313 non-operated patients.
    • Neurologic morbidity risk was highest with advanced carotid stenosis.
    • Carotid endarterectomy in 57 patients resulted in one stroke (1.6%).

    Conclusions:

    • Asymptomatic cervical bruit carries a significant risk of stroke, particularly with advanced carotid stenosis.
    • Carotid endarterectomy is a safe and effective intervention for selected patients with severe carotid stenosis.
    • Identification and surgical management of high-risk patients can reduce neurologic morbidity.