USPSTF Updates Asymptomatic Carotid Artery Stenosis Screening Recommendations

In an updated recommendation, the US Preventive Services Task Force (USPSTF) continues to advise against screening for asymptomatic carotid artery stenosis in the general adult population.

This recommendation reaffirms the group’s 2014 recommendation by addressing key questions on the benefits and harms of screening and treatment. Included in this D recommendation are adults without a history of transient ischemic attack, stroke, or other neurologic signs or symptoms relating to the carotid arteries.

The update also included takeaways on risk assessment, screening, and treatment:

• Individuals that are older, male, smoke, have hypertension, hypercholesterolemia, diabetes, or heart disease are at an increased risk for carotid artery stenosis.
• Carotid duplex ultrasonography, magnetic resonance angiography, and computer tomorgraphy angiography are among the recommended screening tests, while auscultation for carotid bruits is not.
• Common courses of treatment include statins, antiplatelet medications, management of hypertension and diabetes, lifestyle modifications, and surgery.

“The USPSTF found no new substantial evidence that could change its recommendation and therefore concludes with moderate certainty that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits,” the update concludes.

—Leigh Precopio

Reference:

US Preventive Task Force. Screening for asymptomatic carotid artery stenosis: US preventive services task force recommendation statement. JAMA. 2021;325(5):476-481. 10.1001/jama.2020.26988