Patients with blocked neck arteries need screening for stroke risk only if they have other risk factors, according to new guidelines from the American Heart Association/American Stroke Association, American College of Cardiology and other groups.A committee of stroke prevention specialists issued the guidelines after agreeing there is not sufficient evidence of benefit from widespread screening. The members hope the guidelines provide new information to help clinicians determine treatment approaches for their patients.
Screening is useful “if your doctor hears abnormal blood flow when listening to your [carotid] arteries, or if you have two or more risk factors for stroke (such as high cholesterol or a family history),” said Jonathan L. Halperin, MD, co-chairman of the writing committee and professor of medicine at the Mount Sinai School of Medicine in New York, in a news release.
Risk factors for stroke include age, family history of stroke, high blood pressure, high blood cholesterol, diabetes, obesity, atrial fibrillation, physical inactivity, sickle cell disease and other heart or blood vessel diseases.
The committee also issued recommendations regarding carotid endarterectomy and carotid stenting, two procedures for treating arteries. Both procedures are reasonable and safe, according to the committee, when arteries are more than 50% blocked.
“The guidelines support carotid surgery as a tried-and-true treatment for most patients,” said Thomas G. Brott, MD, committee co-chairman and professor of neurology and director of research at the Mayo Clinic campus in Jacksonville, Fla.
“However, for patients who have a strong preference for less invasive treatments, carotid stenting offers a safe alternative. Because of the anatomy of their arteries or other individual considerations, some patients may be more appropriate for surgery and others for stenting.”
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This will be good news for people for who Carotid Endarterectomy has been suggested.
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However, there was no difference in rates of inhospital mortality based on the time of admission, Abby Kazley, PhD, of the Medical University of South Carolina in Charleston, and colleagues reported in the January issue of Archives of Neurology.
