Why the study?
What is the natural history and rate of clinical events in patients with asymptomatic extracranial arterial disease followed by non-invasive ultrasound?
What is the natural history and rate of clinical events in patients with asymptomatic extracranial arterial disease followed by non-invasive ultrasound?
Asymptomatic extracranial arterial disease is associated with a high long-term mortality rate but a low stroke rate, with vascular progression predicting future cerebrovascular events.
High mortality but low stroke rates in asymptomatic disease may favor conservative management; leaves open whether progression monitoring improves risk stratification.
Various non-invasive techniques were used to study clinical and ultrasound aspects of extracranial arterial disease. cw Doppler was used prospectively to study the natural history of asymptomatic extracranial arterial disease (greater than 50% carotid stenosis, subclavian steal phenomena) in 401 patients. Whereas the cumulative death rate was high (44%) at 8 years, the stroke rate was low (6%). Progression of the vascular processes during follow-up correlated with later cerebrovascular events. Transcranial PW Doppler was used to study the intracranial collaterlisation in 151 asymptomatic patients with significant extracranial lesions. The majority of patients showed excellent collateralisation. The natural history of non-stenotic plaques (less than 30% carotid stenosis) was studied by means of high-resolution (10 MHz) duplex system analysis. Whilst most plaques remained constant during the subsequent follow-up period progression was seen in 24% and regression in 10%.
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Rautenberg et al. (1989) studied this question.
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