This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal

Wesley S. Moore, MD; Clark Boren, MD; James M. Malone, MD; Anthony J. Roon, MD; Ronald Eisenberg, MD; Jerry Goldstone, MD; Richard Mani, MD

Arch Surg. 1978;113(11):1352-1359.

Abstract
• To define the natural history of the asymptomatic, nonstenotic, ulcerative lesion involving the carotid artery bifurcation, the arteriograms and clinical course of 67 patients with 72 asymptomatic ulcerative lesions of the carotid artery were reviewed. The angiographic appearance of ulceration was classified into three groups: minimal (group A), large (group B), and compound (group C).

Using life-table methods, the clinical course of these patients was compared between groups and was also compared to a nonrandomized surgically treated group of patients with nonstenotic ulcerative lesions in whom operation was performed for hemispheric or monocular symptoms.

There were no significant (P >.1) differences in mortality, but the differences in stroke incidence was highly significant (P <.001). The annual stroke rate, averaged over seven years, was 0.4% per year for group A, 1.47% per year for the surgically treated group, and 12.5% per year for groups B and C. The data indicate that group A ulcers have a benign prognosis, in noticeable contrast to group B and C ulcers which incur a high risk for subsequent stroke.

(Arch Surg 113:1352-1359, 1978)

Author Affiliations
From the Department of Surgery (Drs Moore and Malone), University of Arizona, Tucson, and the Department of Surgery (Drs Boren, Roon, and Goldstone) and Radiology (Drs Eisenberg and Mani), Veterans Administration Hospital, University of California, San Francisco.

Footnotes
Accepted for publication July 24, 1978.

Presented at the 26th meeting of the International Cardiovascular Society, Los Angeles, June 24, 1978.

Reprint requests to Department of Surgery, Arizona Health Sciences Center, Tucson, AZ 85724 (Dr Moore).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Editorial Comment--Plaque Pathology and Patient Selection for Carotid Endarterectomy
Findlay
Stroke 2005;36:257-258.
FULL TEXT  

Significance of Sonographic Tissue and Surface Characteristics of Carotid Plaques
Tegos et al.
Am. J. Neuroradiol. 2001;22:1605-1612.
ABSTRACT | FULL TEXT  

Natural History of Asymptomatic Carotid Stenosis: When Should We Operate and Why?
Muluk
PERSPECT VASC SURG ENDOVASC THER 1999;12:15-26.
ABSTRACT  

Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery
Gronholdt
Arterioscler. Thromb. Vasc. Bio. 1999;19:2-13.
ABSTRACT | FULL TEXT  

Guidelines for Carotid Endarterectomy : A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association
Biller et al.
Circulation 1998;97:501-509.
FULL TEXT  

Guidelines for Carotid Endarterectomy : A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association
Biller et al.
Stroke 1998;29:554-562.
FULL TEXT  

When Should Carotid Endarterectomy be Performed on the Basis of Carotid Noninvasive Examination Alone?
Purcell and Brewster
PERSPECT VASC SURG ENDOVASC THER 1998;9:1-15.
ABSTRACT  

Functional and Anatomic Evaluation of Carotid Atherothrombosis : A Combined Study of Indium 111 Platelet Scintigraphy and B-Mode Ultrasonography
Moriwaki et al.
Arterioscler. Thromb. Vasc. Bio. 1995;15:2234-2240.
ABSTRACT | FULL TEXT  

Asymptomatic Carotid Stenosis and Risk of Stroke: A Natural History Study
Nicolaides and Thomas
CLIN APPL THROMB HEMOST 1995;1:202-208.
ABSTRACT  

Guidelines for Carotid Endarterectomy : A Multidisciplinary Consensus Statement From the Ad Hoc Committee, American Heart Association
Moore et al.
Circulation 1995;91:566-579.
ABSTRACT | FULL TEXT  

Guidelines for Carotid Endarterectomy : A Multidisciplinary Consensus Statement From the Ad Hoc Committee, American Heart Association
Moore et al.
Stroke 1995;26:188-201.
ABSTRACT | FULL TEXT  

Risk-Benefit Aspects of Surgery for Asymptomatic Carotid Artery Stenosis
Colburn and Moore
PERSPECT VASC SURG ENDOVASC THER 1994;7:6-30.
 

Management of Coexistent Carotid and Coronary Artery Atherosclerotic Disease: An Unresolved Controversy: Report of Clinical Experience and Literature Review
Berman et al.
VASC ENDOVASCULAR SURG 1991;25:541-549.
ABSTRACT  

Correlative Angiographic and Pathologic Findings in the Diagnosis of Ulcerated Plaques in the Carotid Artery
Estol et al.
Arch Neurol 1991;48:692-694.
ABSTRACT  

Carotid Surgery in the Community Hospital
Rubin and Graham
PERSPECT VASC SURG ENDOVASC THER 1990;3:30-41.
 

Asymptomatic Carotid Lesions After Endarterectomy of Contralateral Carotid Artery: Five-Year Follow-up Study and Prognosis
Schroeder et al.
Arch Surg 1987;122:795-801.
ABSTRACT  

Asymptomatic Carotid Bruit and Stenosis: A Prospective Follow-up Study
Ford et al.
Arch Neurol 1986;43:219-222.
ABSTRACT  

Natural History of Asymptomatic Carotid Plaque
Johnson et al.
Arch Surg 1985;120:1010-1012.
ABSTRACT  

The Surgical Management of Transient Ischemic Attacks
Brown and Kerstein
ANGIOLOGY 1984;35:12-21.
 

The Underlying Problems Resulting in Controversies in the Clinical Management of Transient Ischemic Attacks: An Overview
Slade et al.
ANGIOLOGY 1983;34:639-645.
ABSTRACT  

Natural History of Nonstenotic, Asymptomatic Ulcerative Lesions of the Carotid Artery: A Further Analysis
Dixon et al.
Arch Surg 1982;117:1493-1498.
ABSTRACT  

Prognosis of Patients With Transient Ischemic Attacks and Normal Angiograms
Mendelowitz et al.
Arch Surg 1981;116:1587-1591.
ABSTRACT  

Prognosis of Asymptomatic Ulcerating Carotid Lesions
Kroener et al.
Arch Surg 1980;115:1387-1392.
ABSTRACT