SHOULD YOU HAVE ULTRASOUND SCREENING FOR CAROTID ARTERY STENOSIS?
This issue was discussed in a recent edition of the Annals of Internal Medicine. The conclusion was that there is no advantage in doing carotid endarterectomy or carotid stenting instead of “best medical therapy” in patients without symptoms. The guideline did not focus on management of symptomatic cases. Best medical therapy includes control of risk factors, including hypertension, diabetes, elevated cholesterol, smoking, obesity, lack of exercise, excessive alcohol.
The incidence of carotid artery stenosis is 1% in the general population. Screening would result in many false positive results, which may lead to unnecessary tests and surgery, which carries risk of stroke.
“Executive physicals” that offer carotid artery screening as well as whole body CT screening are probably unwise. According to Dr Philip Gorelick, “When the ultrasound truck pulls up to your local shopping mall or church and offers a battery of tests, a bad result can make people think they have a ticking time bomb in their neck.”
Contact our center at (714) 738-0800 or via email