The Role of Carotid Bruit in Screening for Carotid Stenosis

Letters15 October 1997The Role of Carotid Bruit in Screening for Carotid StenosisTina T. Lee, MD, Paul A. Heidenreich, MD, and Neil A. Solomon, MDTina T. Lee, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612, Paul A. Heidenreich, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612, and Neil A. Solomon, MDStanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-8_Part_1-199710150-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Rea's query concerns a common, clinically important question. Published data suggest that the presence of carotid bruit is a reasonably accurate indicator of carotid stenosis in symptomatic persons. Fewer data are available with which to assess its role in asymptomatic persons. In symptomatic persons, Ziegler and colleagues [1] found a sensitivity of 0.29 and a specificity of 0.88 for detecting stenosis greater than 50%; the collaborators of the North American Symptomatic Carotid Endarterectomy Trial [2] found a sensitivity of 0.62 and a specificity of 0.61 for detecting stenosis of 70% to 99%; and Hankey and Warlow [3] ...References1. Ziegler DK, Zileli T, Dick A, Sebaugh JL. Correlation of bruits over the carotid artery with angiographically demonstrated lesions. Neurology. 1971; 21:860-5. Google Scholar2. Sauve JS, Thorpe KE, Sackett DL, Taylor W, Barnett HJ, Haynes RB, et al. Can bruits distinguish high-grade from moderate symptomatic carotid stenosis? The North American Symptomatic Carotid Endarterectomy Trial. Ann Intern Med. 1994; 120:633-7. Google Scholar3. Hankey GJ, Warlow CP. Symptomatic carotid ischaemic events: safest and most cost effective way of selecting patients for angiography, before carotid endarterectomy. BMJ. 1990; 300:1485-91. Google Scholar4. Fowl RJ, Marsch JG, Love M, Patterson RB, Shukla R, Kempczinski RF. Prevalence of hemodynamically significant stenosis of the carotid artery in an asymptomatic veteran population. Surg Gynecol Obstet. 1991; 172:13-6. Google Scholar5. Wolf PA, Kannel WB, Sorlie P, McNamara P. Asymptomatic carotid bruit and risk of stroke. The Framingham study. JAMA. 1981; 245:1442-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Stanford University; Stanford, CA 94305Kaiser Permanente; Oakland, CA 94612 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFocused screening for occult carotid artery disease: patients with known heart disease are at high riskAsymptomatic Internal Carotid Artery Stenosis Defined by Ultrasound and the Risk of Subsequent Stroke in the Elderly 15 October 1997Volume 127, Issue 8_Part_1Page: 657-658 Issue Published: 15 October 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...