Long-term prognosis after carotid artery occlusion.

One hundred thirty eight patients with angiographically proved carotid artery occlusion and minimal or no neurologic deficit were followed up for an average of 5 years. For patients 35 years old or over, the observed 5-year survival rate on an actuarial basis was 77% compared with an expected rate of 85% in a matched normal population. For patients 35 years old or over, the subsequent stroke rate was 3% per year, and two-thirds of the strokes were ipsilateral to the carotid artery occlusion. The observed stroke rate for all patients 35 years old or over was eight times the expected rate for a matched normal population. The relative risk of stroke was much greater in the younger patients with atherosclerotic carotid artery occlusion than in the older patients.