| Abstract: | The natural history of a group of 76 patients without neurological symptoms, but with untreated extracranial arterial disease demonstrated by angiography 10 years ago, was studied. During this period 46 patients died, and coronary artery disease was the most common cause of death (n = 25). Six patients suffered a lethal stroke, five patients had a stroke before they died from other causes and five of the six surviving patients, who became symptomatic developed TIAs, followed by a stroke in two cases, leaving only one who suffered a sudden stroke without premonitory warning symptoms. Although the overall cumulative stroke rate (18 per cent) was three times higher than normal, the cerebrovascular territories affected corresponded only twice with the original extracranial carotid lesion. Therefore, early carotid endarterectomy is inadvisable for the majority of asymptomatic patients and repetitive non-invasive prospective study of these patients is favoured for selection of more appropriate timing for individual treatment. |
