Importance: Many @entity1 with asymptomatic @entity543 are offered carotid stenting for the prevention of @entity432 . However, this treatment may be inappropriate if the risk of @entity64 is low at the time of @entity432 and with intensive medical therapy. Objectives: To determine the risk resulting from progression to @entity432 among @entity1 with asymptomatic @entity543 and to assess the role of severity of @entity543 or the presence of contralateral @entity432 as factors that may predict the risk of @entity64 or @entity204 after @entity432 of a previously asymptomatic @entity543 . Design, Setting, and @entity1 : We conducted a retrospective analysis of data collected from @entity1 at the @entity64 Prevention Clinic of Victoria Hospital from January 1, 1990 (when annual surveillance with carotid ultrasonography first began), through December 31, 1995, or the @entity64 Prevention at University Hospital from January 1, 1995, through December 31, 2012. The last date of follow-up was August 26, 2014. Exposures: A new @entity432 during annual monitoring with carotid duplex ultrasonography (index @entity432 ). Main Outcomes and Measures: Ipsilateral @entity64 or transient @entity63 attack, @entity204 from @entity64 , or @entity204 from unknown cause. Results: Among 3681 @entity1 in our clinic database with data on sequential annual carotid ultrasonographic examinations during the study period, 316 (8.6%) were asymptomatic before an index @entity432 that occurred during observation. Most of the new occlusions (254 of 316 [80.4%]) occurred before 2002, when medical therapy was less intensive; the frequency decreased by quartile of years (P   <   .001,   2 test). Only 1 @entity1 (0.3%) had a @entity64 at the time of the @entity432 , and only 3 @entity1 (0.9%) had an @entity64 during follow-up (all before 2005). In Kaplan-Meier survival analyses, neither severity of @entity850 (P   =   .80, log-rank test) nor contralateral @entity432 (P   =   .73) predicted the risk of @entity64 or transient @entity63 attack, @entity204 from @entity64 , or @entity204 from unknown cause at a mean (SD) follow-up of 2.56   (3.64) years. In Cox proportional hazards regression analyses, only age (P   =   .02), sex (P   =   .01), and carotid plaque burden (P   =   .006) significantly predicted risk of those events. Conclusions and Relevance: The risk of progression to @entity432 is well below the risk of carotid stenting or endarterectomy and has decreased markedly with more intensive medical therapy. Preventing @entity432 may not be a valid indication for stenting.

Risk of XXXX at the Time of Carotid Occlusion.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Participants'] @entity64 :: ('MESH:D020521', 'Disease') :: ['ipsilateral stroke', 'stroke', 'Stroke'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity432 :: ('MESH:D001157', 'Disease') :: ['carotid occlusion', 'occlusion'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity543 :: ('MESH:D016893', 'Disease') :: ['carotid stenosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke']
