Prognostic significance of severity of carotid atheroma in early manifestations of cerebrovascular disease.

Two hundred and fifteen patients with transient ischaemic attacks, reversible ischaemic neurological deficit, or completed stroke were studied angiographically. The appearances of the carotid bifurcation were classified as normal, irregular, stenosed or occluded and the possible prognostic significance of the angiographic categories sought in a follow up study. Over a mean follow up period of 4.1 years 12% of patients were found to have died, and 10% had had a stroke. Fourteen percent had TIAs and 5.1% had sustained a myocardial infarction. Mortality and stroke risk were greatest with carotid occlusion which was least often followed by TIAs. Strokes, but not TIAs, were less frequent in the presence of normal angiograms.