Structured Abstract

Contents

• 1. Introduction
• 2. Background
  • What is Carotid Artery Stenosis?
  • Prevalence and Clinical Importance of Carotid Artery Stenosis in the General Population
  • CAS-Related Stroke Burden
  • Risk Factors for Carotid Artery Stenosis
• 3. Methods
  • Data Sources and Searches
  • Study Selection
  • Data Extraction and Quality Assessment
  • Data Synthesis and Analysis
  • Role of the Funding Source
• 4. Results
  • Summary of Results
  • Key Question 1. Is there direct evidence that screening adults with ultrasound for asymptomatic CAS reduces fatal and/or nonfatal stroke?
  • Key Question 2. What is the accuracy and reliability of ultrasound to detect clinically important CAS?
  • Key Question 3. For people with asymptomatic CAS 60%–99%, does intervention with CEA reduce CAS-related morbidity or mortality?
  • Key Question 4. Does treatment for asymptomatic CAS 60%–99% with CEA result in harm?
• 5. Discussion
• 6. Emerging Issue - Stenting for Carotic Artery Stenosis
• 7. Research Gaps
• Appendix 1. Literature Search and Inclusion/exclusion Criteria for Key Questions
• Appendix 2. USPSTF Hierarchy of Research Design and Quality Rating Criteria
• Appendix 3. Evidence Table for Randomized Controlled Trials for Effectiveness of Surgery versus Medical Management for Asymptomatic Carotid Artery Stenosis
• Appendix 4. Evidence Table on Complications Rates for Carotid Endarterectomy
• References

Suggested citation:

Wolff T, Guirguis-Blake J, Miller T, Gillespie M, Harris R. Screening for Asymptomatic Carotid Artery Stenosis. Evidence Synthesis No. 50. AHRQ Publication No. 08-05102-EF-1. Rockville, MD: Agency for Healthcare Research and Quality, December 2007.

This general work of the U.S. Preventive Task Force (USPSTF) is supported by the Agency for Healthcare Research and Quality (AHRQ), Rockville, Maryland. This review did not receive separate funding.

The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

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No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in this report.