The records of 628 patients admitted to the Joint Study of Extracranial Arterial Occlusion with transient symptoms of carotid system ischemic disease were examined to determine the accuracy of predicting disease of the extracranial internal carotid artery on the basis of clinical information alone. A patient with a history of episodes of amaurosis fugax is more likely to have a lesion of the internal carotid artery on the same side than if he were having only transient cerebral ischemic attacks. In patients with transient symptoms and a carotid bruit on the appropriate side, the incidence of an angiographically normal carotid artery was 15%. In those patients with transient symptoms and no palpable pulsation in the cervical region on the appropirate side, the incidence of an angiographically normal carotid artery was zero.

Auscultation↗

PubMedDate not supplied

XIV. Cerebral ischemia: the role of thrombosis and of antithrombotic therapy. Study group on antithrombotic therapy.

A revival of interest in antithrombotic agents for the treatment of ischemic cerebrovascular disease has resulted in the widespread use of oral anticoagulants for the prophylaxis and therapy of the ischemic variety of stroke, and has generated enthusiasm for the use of platelet-suppressant agents such as aspirin, dipyridamole, and sulfinpyrazone. In delineating the several clinical types of focal ischemic disease and outlining the causes of cerebral ischemia and infarction, the study group considers the problems of data interpretation in the face of inconsistent terminology. The basic mechanisms of hemostasis and thrombogenesis are concisely detailed. Finally, the study group critically reviews extensive earlier reports of clinical trials of anticoagulants, platelet function suppressants, and thrombolytic agents, and reassesses according to present-day statistical standards the significance of the results. The information contained in this report should familiarize the reader with sufficient data to permit him to utilize antithrombotic agents under a variety of circumstances and to appreciate the contraindications and potential dangers in their use.

Aged↗

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Controlled trial of aspirin in cerebral ischemia.

Adouble-blind trial of aspirin for the treatment of cerebral ischemia was begun in 1972 and continued for 37 months. This was accomplished despite difficulties in controlling a long-term study of a drug which has widespread availability and consumption. The study design, criteria for selection of patients, follow-up surveillance, and methods of data analysis are presented. We report only subjects without carotid surgery before randomization. Patients (178) who had carotid transient ischemic attacks (TIAs) were randomly allocated to aspirin or placebo and followed to determine the incidence of subsequent TIAs,death, cerebral infarction or retinal infarction. Analysis of the first six months of follow-up revealed a statistically significant differential in favar of aspirin when death or cerebral or retinal infarction and the occurrence of TIAs were grouped and considered together as end points. Significance in favor of aspirin treatment was mainly revealed in patients with a history of multiple TIAs and was most evident in those individuals having carotid lesions appropriate to the TIA symptoms. It cannot be inferred from this study that aspirin prevents stroke because when end points were restriced to death or cerebral or retinal infarction, there was no statistically significant differential between the aspirin and placebo treatments.

Aged↗

PubMedDate not supplied

The asymptomatic carotid bruit--operate or not?

Explore the source record for details and available documents.

Arterial Occlusive Diseases↗

PubMedDate not supplied

Controlled trial of aspirin in cerebral ischemia. Part II: surgical group.

Patients (125) who had carotid transient ischemic attacks (TIAs) and one or more accessible carotid lesions visualized angiographically had reconstructive operations of the carotid artery and were then randomly assigned to aspirin or placebo treatment. The were followed to determine the incidence of subsecquent TIAs, death, cerebral infarction, or retinal infarction. Life table analysis (for 24 months follow up) that eliminated deaths which were not stroke-related revealed a significant difference in favor of aspirin. Because of the small number of patients and the short period of follow up, these results should be interpreted only as consistent with those reported in the initial publication but not conclusive of an aspirin effect in preventing cerebral infarction.

Adult↗