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S. J. Bakri, A. Luqman, B. Pathik, K. Chandrasekaran; The Utility of Carotid Ultrasound in Patients With Hollenhorst Plaques. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1180.
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To identify which clinical characteristic in HP patients are predictive for surgically correctable carotid stenosis.
We reviewed the medical records of 237 patients diagnosed with HP at the Mayo Clinic between 1996 and 2004. Baseline cardiovascular risk profile, medications, and carotid ultrasound findings were documented. No history of retinal ischemia was found in 177 patients. Retinal ischemic symptoms were present in 60 patients. Carotid stenosis >70% was classified as significant.
Eighty one percent of the HP population underwent carotid ultrasound evaluation. Significant stenosis was found in 13.5 %. Although the incidence of significant carotid stenosis was higher in the symptomatic patients than in the asymptomatic (25% vs. 9%; p=0.008), the incidence of carotid endarterectomy was not statistically different between the two groups (13% vs. 8%; p=0.2). Among asymptomatic patients, those with a carotid bruit had higher incidence of significant stenosis than those without a bruit (37%vs. 4%; p=0.001). The number of patients that underwent carotid endarterectomy was also higher in the group with a bruit (38% vs. 3%; p=<0.001). Among symptomatic patients, those with carotid bruit had a higher incidence of significant carotid stenosis (36% vs. 13%; p=0.2) and carotid endarterectomy (18% vs. 11.8%; p=0.6) but the difference was not statistically significant.
Although symptomatic patients with HP are more likely to have significant carotid stenosis, in asymptomatic patients, the presence of carotid bruit significantly increases the likelihood identifying significant carotid disease and eventually undergoing carotid endarterectomy.
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