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Stroke risk from symptomless extracranial arterial disease
Lancet (London, England)
|November 27, 1982
Summary
Patients with extracranial arterial disease (EAD) face a low stroke risk (7%), similar to the general population. However, EAD progression is common, with combined carotid and vertebral lesions significantly increasing cerebrovascular risk.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Extracranial arterial disease (EAD) affects numerous individuals, necessitating understanding of its natural history.
- Neurologically symptomless patients with EAD require prospective evaluation to assess risks.
Purpose of the Study:
- To investigate the natural history of prospectively selected, neurologically symptomless patients with EAD.
- To determine stroke incidence, mortality, and disease progression in this cohort.
Main Methods:
- Prospective study of 122 neurologically symptomless patients with EAD.
- Follow-up duration ranged from 11 to 36 months (mean 17 months).
- Life-table analysis and continuous-wave Doppler examinations were employed.
Main Results:
- 23 out of 122 patients died; 3 from stroke and 10 from cardiac failure.
- The cumulative stroke rate was 7%, comparable to the average risk in a normal population.
- EAD progression occurred in 85% of patients, with combined carotid and vertebral lesions being a significant indicator of cerebrovascular risk (six times higher than carotid lesions alone).
Conclusions:
- While the overall stroke risk for neurologically symptomless EAD patients is low, EAD progression is highly probable.
- Combined carotid and vertebral arterial lesions represent a critical risk factor for cerebrovascular events.