Asymptomatic 50% to 75% internal carotid artery stenosis in 288 patients: risk factors for disease progression and ipsilateral neurological symptoms

Perspect Vasc Surg Endovasc Ther. 2012 Dec;24(4):165-70. doi: 10.1177/1531003513491986. Epub 2013 Jun 26.


Introduction: This study identified characteristics of patients with moderate internal carotid artery stenosis that are at increased risk for disease progression.

Methods: Patients with asymptomatic moderate internal carotid disease correlating to 50% to 75% diameter reduction were followed for 3 years. Progression to greater than 75% diameter reduction or presentation with focal neurological symptoms was documented. Descriptive statistics and χ(2) testing provided statistical analysis.

Results: During follow-up, 26 (9%) developed symptoms or had an asymptomatic increase in diameter reduction to >75%. The rate of disease progression and/or development of symptoms was 5.5% at 12 months and increased to 7.2% by 24 months. Comorbidities with the highest associated event incidences were coronary artery disease (8.1%), hyperlipidemia (7.3%), and hypertension (6.7%).

Conclusion: Male patients with coronary artery disease, hyperlipidemia, and hypertension are at increased risk and are candidates for frequent screening and/or early intervention.

Keywords: asymptomatic carotid stenosis; asymptomatic moderate carotid disease; carotid disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases
  • Carotid Artery, Internal*
  • Carotid Stenosis / diagnosis
  • Carotid Stenosis / epidemiology*
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / epidemiology*
  • Comorbidity
  • Coronary Artery Disease / epidemiology
  • Disease Progression
  • Female
  • Humans
  • Hyperlipidemias / epidemiology
  • Hypertension / epidemiology
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Time Factors
  • Wisconsin / epidemiology