Screening for Asymptomatic Carotid Artery Stenosis in the General Population: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force | Cerebrovascular Disease | JAMA | JAMA Network
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1.
Jonas  DE, Feltner  C, Amick  HR,  et al.  Screening for Asymptomatic Carotid Artery Stenosis: A Systematic Review and Meta-Analysis for the U.S. Preventive Services Task Force. Evidence Synthesis No. 111. Agency for Healthcare Research and Quality; 2014.
2.
LeFevre  ML; US Preventive Services Task Force.  Screening for asymptomatic carotid artery stenosis: U.S. Preventive Services Task Force recommendation statement.   Ann Intern Med. 2014;161(5):356-362. doi:10.7326/M14-1333PubMedGoogle ScholarCrossref
3.
Procedure manual. US Preventive Services Task Force. Updated 2017. Accessed November 24, 2020. https://www.uspreventiveservicestaskforce.org/uspstf/procedure-manual
4.
Guirguis-Blake JM, Webber EM, Coppola EL.  Screening for Asymptomatic Carotid Artery Stenosis in the General Population: An Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 199. Agency for Healthcare Research and Quality; 2020. AHRQ publication 20-05268-EF-1.
5.
Reiff  T, Eckstein  HH, Mansmann  U,  et al.  Angioplasty in asymptomatic carotid artery stenosis vs. endarterectomy compared to best medical treatment: one-year interim results of SPACE-2.   Int J Stroke. 2019;15(6):1747493019833017. doi:10.1177/1747493019833017PubMedGoogle Scholar
6.
Kolos  I, Troitskiy  A, Balakhonova  T,  et al; Aggressive Medical Treatment Evaluation for Asymptomatic Carotid Artery Stenosis (AMTEC) Study Group.  Modern medical treatment with or without carotid endarterectomy for severe asymptomatic carotid atherosclerosis.   J Vasc Surg. 2015;62(4):914-922. doi:10.1016/j.jvs.2015.05.005PubMedGoogle ScholarCrossref
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    Research Letter
    February 2, 2021

    Screening for Asymptomatic Carotid Artery Stenosis in the General Population: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

    Janelle M. Guirguis-Blake, MD1; Elizabeth M. Webber, MS2; Erin L. Coppola, MPH2
    Author Affiliations Article Information
    • 1Department of Family Medicine, University of Washington, Tacoma
    • 2Kaiser Permanente Evidence-based Practice Center, Kaiser Permanente Center for Health Research, Portland, Oregon
    JAMA. 2021;325(5):487-489. doi:10.1001/jama.2020.20364
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    Carotid artery stenosis is a known stroke risk factor and a cardiovascular disease marker. No population-based screening trials for carotid artery stenosis have been conducted. Optimal treatment for clinically significant asymptomatic carotid artery stenosis remains uncertain. Options include best medical therapy alone or in combination with revascularization (carotid endarterectomy or carotid artery stenting) to prevent stroke. Revascularization has been associated with small long-term benefits compared with best medical therapy alone in historic trials but can result in surgical harms.1

    Since 2007, the US Preventive Services Task Force (USPSTF) has maintained a D recommendation against screening for asymptomatic carotid artery stenosis in the general adult population. This recommendation was based on a low prevalence of stroke attributable to asymptomatic carotid artery stenosis in the general population, the small benefit of surgery compared with medical therapy in older trials, and the potential for small to moderate surgical harms. This brief evidence update aimed to identify studies published since the previous 2014 review1 to inform an updated USPSTF recommendation.

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