Prevalence of significant carotid artery stenosis in patients with transient ischaemic attack.

Background: Carotid artery stenosis is one of the risk factors for transient ischaemic attack (TIA) and stroke. The purpose of this study was to investigate the prevalence of carotid artery stenosis and the prevalence of candidates for carotid endarterectomy in a hospital-based cohort of TIA patients under 71 years of age.

Methods: This retrospective study included 205 patients with TIA admitted to an acute stroke unit. A carotid Doppler sonography was performed in 114 patients with TIAs in the internal carotid artery territory and a mean age of 60 years. Based on Doppler examinations, the patients were divided into 4 groups according to the following degrees of stenosis: 40-59%, 60-79%, 80-99% stenosis, and occlusion.

Results: Doppler examinations showed that 5% had a 40-59% stenosis, 5% had stenosis >60% and 4% had occlusion of the relevant internal carotid artery. Carotid endarterectomy was done in 2% of the patients. Carotid artery stenosis was associated with a history of angina pectoris and myocardial infarction in univariate analysis, but not in multivariate analysis.

Conclusions: The prevalence of significant carotid artery stenosis on the relevant side in patients with TIA was quite low: only 5% had a degree of stenosis where carotid endarterectomy should be considered. Only 2% eventually had carotid endarterectomy.