M. Leon et al., PROGRESSION OF CAROTID ATHEROSCLEROSIS - 3-YEAR FOLLOW-UP AND ANALYSIS OF RISK-FACTORS, Journal of Cardiovascular Surgery, 34(6), 1993, pp. 461-464
Objective. To elicit the risk factors associated with increasing grade
s of stenosis in patients with carotid plaque. Study design. Retrospec
tive review of serial duplex scans of the carotid bifurcation. Case no
te review for documented risk factors. Setting. Irvine Laboratory of t
he Academic Department of Surgery, Vascular Section. Patients and resu
lts. Review of serial duplex scans of the carotid bifurcation was perf
ormed on 200 unselected patients who each had a follow-up of at least
three years. Definite progression of carotid atherosclerosis was defin
ed as an unequivocal increase in at least one grade by the criteria of
Strandness, and was documented in 50 patients (25%). Even if the init
ial situation is normal or minimal disease (<15% stenosis), once defin
ite plaque progression is observed, the lesion will progress to a hemo
dynamically significant one (>50%)in 67% of this patient population. T
he only risk factor for plaque progression that we defined is hyperten
sion, and this may be spurious. There are no risk factors associated w
ith the subgroup of plaques that progress rapidly above those that pro
gress at a slower rate. Conclusions. There are no risk factors defined
in this population which are associated with advancing carotid athero
sclerosis.