Tests for silent neck artery narrowing to curb stroke risk—Waste of resources

September 5, 2012

Tests to screen for "silent" neck artery narrowing in a bid to curb the risk of a stroke result in many unnecessary and costly surgical procedures, and ultimately save very few lives, concludes an editorial in the Journal of NeuroInterventional Surgery.

In 2-6% of European men aged 60 plus, the supplying the brain (carotid arteries) are narrowed by 50-99%. This condition, termed or atherosclerosis, accounts for 10-15% of strokes (data not in paper).

Carotid atherosclerosis is commonest in those with mild in their legs, a condition known as .

In this group the prevalence of silent carotid atherosclerosis is 15%. As they are already under the care of a vascular specialist, they are considered ideal candidates to test for silent carotid atherosclerosis.

But debate rages as to whether to screen for carotid atherosclerosis to stave off a stroke: the Royal College of Physicians does not currently recommend it, but the US Society for Vascular Surgery strongly backs testing in selected groups.

Those found to have severe (70-99%) carotid narrowing on screening are offered surgical treatment ().

But 133 people with claudication would need to be tested to pick up 20 patients eligible for surgery, and this would only prevent a single stroke, at a cost of around £76, 000, say the authors.

If this policy were to be introduced into England and Wales at age 60 for those with mild peripheral arterial disease, it would cost £17.5 million a year, on the basis that around 669 000 would be eligible for an ultrasound scan, 4600 of whom would then require surgery.

But all this effort would still only prevent 231 strokes, even in this high risk group, equivalent to around 0.2% of all 110,000 strokes sustained in 2010, say the authors.

"The hazards of overdiagnosis have recently been highlighted, and perhaps it is time to realise why it has been recommended that we stop testing for asymptomatic carotid atherosclerosis in the UK," they conclude.

Explore further: Better diagnostics could reduce risky surgery for asymptomatic carotid stenosis

Related Stories

Better diagnostics could reduce risky surgery for asymptomatic carotid stenosis

August 17, 2011
New research from Neurologist Dr. David Spence of The University of Western Ontario has shown that using 3-D ultrasound to identify ulcers in the carotid arteries is an effective way to pinpoint the small number of high-risk ...

Researchers study outcomes of carotid artery stenting following prior carotid procedure

November 14, 2011
A new study shows that carotid artery stenting (CAS) following prior same-side carotid artery revascularization is safe, effective and results in lower incidences of in-hospital death, stroke and heart attack compared to ...

Recommended for you

Defining optimal opioid pain medication prescription length following surgery

September 27, 2017
A new study led by researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital analyzed opioid prescription data from the Department of Defense Military Health System Data Repository, identifying ...

Is older blood OK to use in a transfusion?

September 27, 2017
(HealthDay)—Using older red blood cells to give transfusions to critically ill patients doesn't appear to affect their risk of dying, Australian researchers report.

One weight-loss surgery shows lasting results

September 21, 2017
(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.

Hold the phone: An ambulance might lower your chances of surviving some injuries

September 20, 2017
Victims of gunshots and stabbings are significantly less likely to die if they're taken to the trauma center by a private vehicle than ground emergency medical services (EMS), according to results of a new analysis.

Surgeons have major influence on breast cancer treatment

September 13, 2017
A woman's choice of surgeon plays a significant role in whether she's likely to receive an increasingly popular aggressive breast cancer surgery.

Some thyroid cancer patients can safely delay surgery

September 4, 2017
Most people diagnosed with cancer want to start treatment as soon as possible, for fear that delaying care will allow their tumor to grow out of control.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.