Significance of asymptomatic carotid bruits

To assess the significance of the asymptomatic carotid bruit, the subsequent occurrence of symptomatic cerebrovascular insufficiency and stroke in 256 patients who had undergone operation for atherosclerosis arterial occlusive disease of the lower extremities was documented during a period of two to seven years postoperatively. At the time of operation, none had had a stroke or exhibited symptoms of cerebrovascular insufficiency, but 60 of the 256 patients had audible carotid bruits. A statistically significant difference was demonstrated: 21 (35%( of the 60 patients with carotid bruits exhibited manifestations of cerebrovascular insufficiency, in contrast to 30 (16%) of the 196 patients without bruits. It seems that detection of an asymptomatic carotid bruit is not an innocent finding, but rather predicts a higher incidence of cerebrovascular complications than that expected on the basis of generalized atherosclerosis alone.