The fate of a patent carotid artery contralateral to an occlusion

The finding of carotid stenosis contralateral to a carotid occlusion is bec oming more frequent. While the neurologic outcomes in this patient populati on have been described, the rate of disease progression measured by duplex examination and the eventual need for carotid endarterectomy has not been d escribed. In this study, a computerized database of carotid duplex examinat ions was reviewed and clinical data were obtained from clinic records. From 9124 studies 117 patients were identified. Thirty patients had previous ca rotid surgery on the patent side and were excluded. Of 87 patients 33 requi red carotid endarterectomy on the patent side. The rate of disease progress ion and/or the performance of a carotid endarterectomy by life-table analys is was 85.9% over 8 years. There were 10 neurologic events during the follo w-up period. Patients with carotid stenosis and contralateral occlusion are at significant risk for disease progression. Follow-up should be more freq uent and of longer duration in this patient population. A significant numbe r of patients with carotid artery occlusion will require a carotid endarter ectomy of the patent contralateral carotid. DOI: 10.1007/s100169910014.