"Patients with symptomatic carotid stenosis don't get the surgical procedure early enough, and patients with asymptomatic carotid stenosis have too many surgical interventions," Marquardt said.
When treating asymptomatic carotid stenosis, Marquardt doesn't think the case has been made for distinguishing between high- and low-risk patients. Right now, the work done by Topakian's group is still "experimental," he said.
Another expert, Dr. Larry B. Goldstein, director of the Duke University Stroke Center, said that "what remains uncertain is whether surgical intervention would result in an overall improvement in stroke-free survival."
"It is also unclear how optimal medical management [lifestyle changes in addition to anti-platelet medication and statins] would affect overall stroke and cardiovascular risk, and stroke-free survival," he said.
Both the U.S. Preventive Services Task Force and the American Heart Association currently recommend against general population screening for asymptomatic carotid artery stenosis, Goldstein noted.
For more information on stroke, visit the U.S. National Library of Medicine.
SOURCES: Raffi Topakian, M.D., Academic Teaching Hospital Wagner-Jauregg, Linz, Austria; Lars Marquardt, M.D., Ph.D., professor, surgery, University of Erlangen-Nuremberg, Germany; Larry B. Goldstein, M.D., director, Duke University Stroke Center, Durham, N.C.; Aug. 17, 2011, Neurology, online
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