Asymptomatic stenoses of carotid arteries

Ignatiev I.M.

Interregional Clinical and Diagnostic Centre Course of Cardiovascular Surgery of the Kazan Medical University, Kazan, Russia

The study was aimed at determining the prevalence of carotid artery stenoses while carrying out a screening population examination and at specifying the indications for endarterectomy in symptom-free patients.

We carried out a screening examination by means of duplex scanning of 624 people (495 men and 129 women) aged over 50 years old and having no transient or persistent neurological symptoms or a history of an endured ischaemic stroke. The patients’ average age amounted to 58.8±8.7 years. The examined patients were subdivided into two groups. Group One was composed of 485 patients presenting with various risk factors for the development of stroke: arterial hypertension, CAD, diabetes mellitus, hereditary predisposition. Group Two consisted of 139 subjects with no evident manifesting signs of cardiovascular diseases. The frequency of revealing ICA stenoses >50% in the group comprising patients with risk factors (14.8%) was significantly higher (p=0.002) than that (4.5%) in the group of apparently healthy people.

From 2009 to 2011 the operation of carotid endarterectomy (CEA) was performed in 89 (15.9% of the total number of CEA) patients with asymptomatic stenoses of carotid arteries (ASCA), ICA stenting was performed in 15 patients. CEA in patients with asymptomatic lesions was carried out in ICA stenoses from 70% to 99%, and in a series of patients with unstable and ulcerated plaques with a high degree of embolization according to the findings of TCDG in stenosis from 60% and more.

There were neither strokes nor lethal outcomes after the operations. Also given is a brief review of the literature covering contemporary problems concerning ASCA.

KEY WORDS: asymptomatic stenoses of carotid arteries, population study, carotid endarterectomy, stenting, medicamentous therapy.

P. 72-84

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