The significance of carotid stenosis or ulceration

Data from the medical treatment group of the Aspirin in TIA study were reviewed, and prospective analysis of patients with asymptomatic bruits was performed to see whether carotid stenosis (0 to 49% or 50 to 99%) or ulceration produced an increased risk of ipsilateral TIA or infarct. In symptomatic arteries, greater than 50% stenosis without ulceration implied a higher risk of subsequent symptoms. Ulceration was associated with an increased risk only in nonstenotic vessels. Lesion anatomy was not related to outcome in asymptomatic arteries, and the incidence of cerebral infarct was low. Factors other than anatomy must play a large role in determining subsequent risk.