Deans' stroke musings: Prognosis of Asymptomatic Carotid Artery Occlusion

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, May 17, 2016

Prognosis of Asymptomatic Carotid Artery Occlusion

Way too many big medical words strung together to have any real understanding of this word salad. My right carotid artery is totally closed up and I'm extremely glad of that.

Prognosis of Asymptomatic Carotid Artery Occlusion

Daniel G. Hackam, MD, PhD

+ Author Affiliations

From the Division of Clinical Pharmacology, Departments of Medicine and Clinical Neurological Sciences and Stroke Prevention and Atherosclerosis Research Centre (SPARC), Robarts Research Institute, Western University, London, Ontario, Canada.

Correspondence to Daniel G. Hackam, MD, PhD, SPARC Unit, Room 100K-2, Siebens Drake Bldg, 1400 Western Rd, London, Ontario, Canada, N6G 2V2. E-mail dhackam@uwo.ca

Abstract

Background and Purpose—The aim of this systematic review was to quantify the risk of ipsilateral stroke in patients with asymptomatic carotid artery occlusion (ACAO).

Methods—Studies reporting ipsilateral stroke risk in ACAO were identified by a search of MEDLINE, EMBASE, and study bibliographies. Study estimates were pooled using a random effects model, and heterogeneity was quantified using the I² statistic. The primary outcome was the annual rate of ipsilateral stroke.

Results—Thirteen studies were identified, encompassing 718 patients with ACAO who were followed up for a median of 2.8 years. The annual rate of ipsilateral stroke was 1.3% (95% confidence interval, 0.4–2.1; I²=53%). The annual rate of ipsilateral transient ischemic attack was 1.0% (95% confidence interval, 0.3–1.8; I²=40%). The annual rate of death was substantially higher at 7.7% (95% confidence interval, 4.3–11.2; I²=83%). Correction for possible publication bias for the primary outcome suggested a lower risk of ipsilateral stroke (0.3% per year; 95% confidence interval, –0.4 to 1.1).

Conclusions—Stroke in ACAO is relatively infrequent, but patients face high mortality rates. This suggests the need for intensified medical therapy in ACAO.