BMJ 1995;311:1436 (25 November)

Letters

Symptomatic carotid lesions in young adults

EDITOR,--In their paper on symptomatic stenoses of the internal carotid artery in young adults (aged 15-44) Antonio Carolei and colleagues conclude that the prognosis was apparently benign in a subgroup with complete occlusions.1 Several factors need to be considered.

Firstly, although carotid angiography was performed in 73% of the study population, the number with occlusions that were angiographically confirmed is unstated.

Secondly, there were only eight patients in this subgroup. Although no neurological events were observed during five years of follow up, the effect of studying such small numbers is reflected by the confidence intervals of 0% to 32.4% for both transient ischaemic attacks and strokes. Other prospective studies, with larger number of patients, suggest that the prognosis after total occlusions may not be entirely benign.2 3 4 5 The variability in reported outcomes (table) may be related to differences in the patency of other extracranial or intracranial vessels in the populations studied. . . . [Full text of this article]


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Relevant Article

Prevalence and outcome of symptomatic carotid lesions in young adults
Antonio Carolei, Carmine Marini, Patrizia Nencini, Carlo Gandolfo, Cristina Motto, Elietta Zanette, Massimiliano Prencipe, and Cesare Fieschi
BMJ 1995 310: 1363-1366. [Abstract] [Full Text]

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