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February 2, 2021

Screening for Asymptomatic Carotid Artery Stenosis in Adult Patients: Unclear Benefit but Downstream Risks

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2San Francisco VA Medical Center, San Francisco, California
  • 3Department of Neurology, University of California, Los Angeles
  • 4VA Greater Los Angeles Healthcare System, Los Angeles, California
JAMA Intern Med. 2021;181(5):585-587. doi:10.1001/jamainternmed.2021.0029
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Carotid artery stenosis is a risk factor for stroke, but a relatively small proportion of strokes (approximately 11%) can be attributed to atherosclerosis of the internal carotid arteries. There is no evidence that screening for carotid artery stenosis in the asymptomatic adult population (ie, no history or symptoms of stroke or transient ischemic attack) will reduce the risk of stroke, but there are downstream risks from identifying patients with carotid stenosis. Thus, in a recommendation statement1 and updated evidence report and systematic review,2 the US Preventive Services Task Force (USPSTF) has reaffirmed its 2014 recommendation3 against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation) based on an assessment of no benefit and possible harm.

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