Duplex Follow-Up Of Asymptomatic Carotid Stenosis: Results Revealed At The VEITH Symposium

Main Category: Cardiovascular / Cardiology
Article Date: 25 Nov 2008 - 6:00 PDT

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The Asymptomatic Carotid Atherosclerosis Study (ACAS) showed a benefit to carotid endarterectomy versos medical therapy in patients with more than 60% stenosis of the internal carotid artery.

As presented today by Glenn Jacobowitz, M.D., Associate Professor of Surgery at the NYU School of Medicine and Vice-Chief, Division of Vascular Surgery at the NYU Medical Center in New York, more recent literature has addressed the benign natural history of moderate carotid stenosis, but the frequency of duplex ultrasound for following moderate stenoses to identify those that progress to high-grade has been a source of controversy.

In addition, carotid stenosis has been identified as risk factor for myocardial infarction and non-stroke vascular death. Various subgroups have been examined, and patients with at least a 50% stenosis, or systolic flow velocities of more than 175cm/sec, have been shown to have up to a 47% incidence of progression to high grade (more than 60%) stenosis over four years. Current recommendation for patients in these subgroups is for duplex scan every six months.

Patients with more mild forms of stenosis can be followed every one to two years. However, with the advent of additional antiplatelet medications, further study is warranted to evaluate the relative risk of stroke in patients with high grade carotid stenosis when surgical or endovascular intervention is compared to modern best medical therapy.

VEITH SYMPOSIUM - New York, November 19th to 23rd

Now in its fourth decade, VEITH SYMPOSIUM provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features rapid-fire presentations from world renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.

VEITHsymposium is sponsored by Cleveland Clinic, Cleveland, OH.

www.veithsymposium.org

Source
Pauline T. Mayer
www.ptmhcm.com