Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

Objective: The aim of this study was to investigate the effect of currently recommended medical treatment (MT) on changes in carotid stenosis in a group of asymptomatic patients taken from the Asymptomatic Carotid Surgery Trial (ACST). Method: Collaborators in ACST were given information on MT for stroke prevention (including antiplatelet agents, lipid-lowering drugs, diabetic and hypertension control). Patients underwent clinical examination and duplex scanning at entry, 4 months following randomisation and annually thereafter. The cohort of patients studied were those randomised to MT with complete follow up duplex datasets at four years (n = 229). None had undergone carotid endarterectomy (CEA) or developed ipsilateral carotid symptoms. Results: There was no change in median carotid stenosis over four years (baseline 79% (IQR 20%) and 4 year median 79% (IQR 10%)) a median difference of 0 with Q1 = -5 and Q3 = +5 (p = 0.98 Wilcoxon one sample test), whilst in many patients' stenoses progressed and regressed during this time. No individual MT variable correlated with stenosis progression or regression. Conclusion: In this group of ACST patients on MT, mean carotid stenosis was unchanged over 4 years. Individual patients' stenoses progressed (and regressed) without symptoms occurring. An increase in stenosis should not be the sole basis for deciding to operate on an asymptomatic patient. © 2002 Elsevier Science Ltd. All rights reserved.

Original publication

DOI

10.1053/ejvs.2002.1649

Type

Journal article

Journal

European Journal of Vascular and Endovascular Surgery

Publication Date

01/01/2002

Volume

23

Pages

519 - 523