In the context of asymptomatic carotid stenosis screening, which statement is most accurate?

• A. It should be widely implemented in the general population
• B. It is always followed by carotid endarterectomy
• C. It is Not recommended to screen asymptomatic individuals
• D. It should be performed annually with Doppler ultrasound

Answer: (C)

Screening asymptomatic individuals for carotid stenosis is not recommended because the overall balance of benefits and harms in the general population favors not screening. Carotid duplex ultrasound can produce false positives, leading to unnecessary confirmatory tests and potentially harmful interventions such as carotid endarterectomy or stenting, which carry risks of stroke, heart attack, or death. The proven benefit of endarterectomy is largely confined to specific high-risk groups with symptoms or to a very select subset of asymptomatic patients with high-grade disease and low surgical risk; screening the broad population does not reliably identify those who would benefit. Therefore, guidelines advocate against routine screening in asymptomatic adults.