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Opinion EDITORIAL Unclear Benefit but Downstream Risks Salomeh Keyhani, MD, MPH; Eric M. Cheng, MD Carotid artery stenosis is a risk factor for stroke, but a rela- “do not do” list. The American Academy of Family Physi- tively small proportion of strokes (approximately 11%) can be cians recommends against screening for asymptomatic attributed to atherosclerosis of the internal carotid arteries. carotid artery stenosis in adult patients. The Society of Vas- There is no evidence that screening for carotid artery steno- cular Surgery recommends against routine surveillance of sis in the asymptomatic adult carotid arteries in the asymptomatic healthy population. population (ie, no history or The Society of Thoracic Surgeons recommends against rou- Multimedia symptoms of stroke or tran- tine evaluation of carotid artery disease prior to cardiac sur- sient ischemic attack) will re- gery in the absence of symptoms or other high-risk criteria. Related articles at duce the risk of stroke, but The American Academy of Neurology recommends against jama.com there are downstream risks imaging of the carotid arteries for simple syncope without jamanetworkopen.com from identifying patients with other neurologic symptoms. There is no national data avail- jama.com carotid stenosis. Thus, in a able on how the USPSTF and
JAMA Internal Medicine – American Medical Association
Published: May 2, 2021
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