Natural History of Nonstenotic, Asymptomatic Ulcerative Lesions of the Carotid Artery

Authors:
  • SDSherwood Dixon
    Sherwood Dixon
  • SPS. Osher Pais
    S. Osher Pais
  • CRCarol Raviola
    Carol Raviola
  • AGAntoinette Gomes
    Antoinette Gomes
  • HMHerbert I. Machleder
    Herbert I. Machleder
  • JBJ. Dennis Baker
    J. Dennis Baker
  • RBRonald W. Busuttil
    Ronald W. Busuttil
  • WBWiley F. Barker
    Wiley F. Barker
  • WMWesley S. Moore
    Wesley S. Moore
Publisher website
Google Scholar
Abstract
• The natural history of 153 asymptomatic, nonstenotic ulcerative lesions of the carotid bifurcation in 141 patients was reviewed. A technique for quantitatively defining small (A), large (B), and compound (C) ulcers was developed. During the course of study, extending up to ten years, 3% of patients with A ulcers, 21% with B ulcers, and 19% with C ulcers had hemispheric strokes without antecedent transient ischemic attacks (TIAs), on the side appropriate to the lesion. The interval annual stroke rate was 4.5% for B ulcers and 7.5% for C ulcers. Because these interval stroke rates are comparable to the 6% annual stroke rate occurring in patients with TIAs, a well-accepted indication for operation, we recommend prophylactic operation for these lesions in good surgical candidates, to be performed by surgeons who have demonstrably low operative stroke rates. (Arch Surg1982;117:1493-1498)

This publication has 2 references indexed in Scilit: