Lancet Sub-Journal: Be alert!

Carotid stenosis is a recognized stroke risk factors and medsci.

Carotid stenosis is a recognized stroke risk factors and medsci.

Prevention Compared with the best drug therapy alone, endovascular treatment has less long-term benefits and may also cause additional surgical damage.

Since 2007, the United States Preventive Services Task Force (USPSTF) has consistently recommended Level D evidence, that is, against screening for asymptomatic carotid stenosis in the general adult population.

JAMA recommends that adults without stroke, neurological symptoms, or transient ischemic attack symptoms do not need to be screened for asymptomatic carotid artery stenosis.

Lancet

The Oxford Vascular Study (OxVasc) is a population-based prospective study and systematic retrospective analysis.

All participants were treated with standardized medications and followed up to determine the risk of ipsilateral stroke in this population.

Between April 1, 2002 and April 1, 2017, a total of 2354 patients were included in the study.

The results showed that the risk of ipsilateral stroke increased with the degree of carotid artery stenosis after 5 years.

After 5 years, the risk of ipsilateral stroke increases with the degree of carotid artery stenosis.

Patients with 70-99% stenosis have a 110% higher risk of stroke than those with 50-69% stenosis, and patients with a stenosis rate of 80-99% have a 150% higher risk than patients with a stenosis rate of 50-79%! Patients with 70-99% stenosis have a 110% higher risk of stroke than those with 50-69% stenosis, and patients with a stenosis rate of 80-99% have a 150% higher risk than patients with a stenosis rate of 50-79%!

Further analysis found that compared with the cohort study, the results of the randomized controlled trial of endarterectomy are highly inconsistent with the results of the cohort study.

There is significant heterogeneity in the risk of stroke between studies of patients with severe and moderate stenosis.

To this end, the researchers pointed out that despite advances in drug therapy, the risk of stroke in patients with highly asymptomatic carotid stenosis is still high, indicating that current guidelines may underestimate the benefits of surgical intervention.

In the future, more large-sample, non-selection-biased intervention RCTs will be needed to demonstrate evidence in this regard.

In the future, more large-sample, non-selection-biased intervention RCTs will be needed to demonstrate evidence in this regard.

references:

Risk of stroke in relation to degree of asymptomatic carotid stenosis: a population-based cohort study, systematic review, and meta-analysis.

Risk of stroke in relation to degree of asymptomatic carotid stenosis: a population-based cohort study, systematic review, and meta-analysis.

 

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