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Article |

Carotid Artery Stenosis—Hemodynamic Significance and Clinical Course

Ronald W. Busuttil, MD, PhD; J. Dennis Baker, MD; Robin K. Davidson, MS; Herbert I. Machleder, MD
JAMA. 1981;245(14):1438-1441. doi:10.1001/jama.1981.03310390038018.
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Two hundred fifteen patients with a history of either stroke, transient ischemic attack (TIA), or asymptomatic carotid bruit underwent noninvasive carotid artery testing using oculopneumoplethysmography. Of patients with hemodynamically significant stenosis, 51 (40.8%) underwent endarterectomy, and 74 (59.2%) were treated nonoperatively. The incidence of stroke in the nonoperated group was 12/74 (16.2%) compared with only 1/51 (1.9%) in the operated group. Similarly, recurrent TIA occurred in 29/74 (39.2%) of the nonoperated group vs 9/51 (17.6%) of the operated. In nonhemodynamically significant carotid stenosis, the risk of cerebrovascular death and stroke was exceedingly low: 2/90 (2.2%). Patients with hemodynamically significant stenosis treated nonoperatively have a greater risk of cerebrovascular death, stroke, and TIA than patients treated with carotid endarterectomy.

(JAMA 1981;245:1438-1441)


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