Article Abstract:
Many patients with asymptomatic carotid artery disease may not benefit from endarterectomy. During endarterectomy, surgeons open the carotid arteries and remove plaque that has accumulated. In a study of 1,820 patients with asymptomatic carotid artery disease on one side and symptomatic carotid artery disease on the other, the annualized risk of stroke on the asymptomatic side was only 1.9%. Many strokes are caused by a blood clot that travels to the brain from some other part of the body. An endarterectomy would not prevent these types of strokes.
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Article Abstract:
Patients with temporary blindness in one eye may benefit from carotid artery surgery because this temporary blindness is a sign of carotid artery disease. Carotid artery disease is a risk factor for stroke, and patients with other risk factors for stroke can benefit even more from surgery.
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Article Abstract:
A number of surgical and non-surgical means of preventing stroke in at-risk patients have been identified. Warfarin, an anticoagulant agent, is used to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. Aspirin is used for patients for whom long-term anticoagulant therapy is unavailable due to age or other heart conditions, but is not as effective as warfarin and the optimum aspirin dose has not been determined. Research suggests that dipyridamole and sulfinpyrazone may be effective treatments in combination with other types of therapy, but neither drug has been shown to reduce the risk of stroke when administered by itself. Surgical options include carotid endarterectomy for patients with severe stenosis, but the ability of endarterectomy to prevent stroke in patients with minimal stenosis is unproven.
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