The asymptomatic carotid bruit

Area of Science:

• Neurology
• Vascular Surgery
• Cardiology

Background:

• Asymptomatic carotid bruits are controversial regarding their stroke risk.
• Understanding the prognostic value of these bruits is crucial for patient management.

Purpose of the Study:

• To determine if asymptomatic carotid bruits are significant risk factors for stroke.
• To evaluate the progression of nonhemodynamically significant bruits to hemodynamically significant ones.

Main Methods:

• 131 asymptomatic carotid bruits in 87 patients were evaluated using Gee oculoplethysmography (OPG).
• Patients were followed for a mean of 34 months, with reevaluations every 6 months.
• Hemodynamic significance was defined by specific ophthalmic artery/brachial artery systolic pressure index criteria.

Main Results:

• 8.4% of bruits were initially hemodynamically significant (HS).
• 11.6% of initially nonhemodynamically significant (NHS) bruits became HS during follow-up.
• Patients with HS bruits had significantly higher stroke (24%) and TIA (16%) incidence compared to NHS bruits (4.8% stroke, 3.2% TIA).

Conclusions:

• Asymptomatic hemodynamically significant carotid bruits confer a high risk of stroke.
• Surgical treatment should be considered for patients with asymptomatic HS carotid bruits.
• The study highlights the importance of monitoring and intervention for specific carotid bruit findings.