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U.S. Preventive Services Task Force

Screening for Carotid Artery Stenosis

Clinical Summary of U.S. Preventive Services Task Force Recommendation

This document is a summary of the 2007 recommendation of the U.S. Preventive Services Task Force (USPSTF) on screening for high blood pressure. This summary is intended for use by primary care clinicians.

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Population Adult General Population1
Recommendation Do not screen with ultrasound or other screening tests.

Grade: D

Risk Assessment

The major risk factors for carotid artery stenosis (CAS) include: older age, male gender, hypertension, smoking, hypercholesterolemia, and heart disease.

However, accurate, reliable risk assessment tools are not available.

Balance of Benefits and Harms

Harms outweigh benefits.

In the general population, screening with carotid duplex ultrasound would result in more false-positive results than true positive results. This would lead either to surgeries that are not indicated or to confirmatory angiography. As the result of these procedures, some people would suffer serious harms (death, stroke, and myocardial infarction) that outweigh the potential benefit surgical treatment may have in preventing stroke.

Other Relevant Recommendations from the USPSTF

Adults should be screened for hypertension, hyperlipidemia, and smoking. Clinicians should discuss aspirin chemoprevention with patients at increased risk for cardiovascular disease.

These recommendations and related evidence are available at http://www.uspreventiveservicestaskforce.org.

1. This recommendation applies to adults without neurological symptoms and without a history of transient ischemic attacks (TIA) or stroke. If otherwise eligible, an individual who has a carotid area TIA should be evaluated promptly for consideration of carotid endarterectomy.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement (PDF File, 330 KB; PDF Help), and supporting documents, go to http://www.uspreventiveservicestaskforce.org.

Copyright and Source Information

This document is in the public domain within the United States.

Requests for linking or to incorporate content in electronic resources should be sent via the USPSTF contact form.

AHRQ Publication No. 08-05102-EF-3
Current as of December 2007

Internet Citation:

U.S. Preventive Services Task Force. Screening for Carotid Artery Stenosis: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 08-05102-EF-3, December 2007. http://www.uspreventiveservicestaskforce.org/uspstf07/cas/cassum.htm


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