scholarly journals Comparative Study of Risk Factors Between Lacunar and Non-lacunar Ischemic Strokes

2013 ◽  
Vol 28 (2) ◽  
pp. 88-95
Author(s):  
Dewan Md Elyas ◽  
Aminur Rahman ◽  
Quazi Deen Mohammad ◽  
Badrul Alam Mondol ◽  
Sakhawat Hossain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Lacunar Stroke ◽  
Group A ◽  
Group B

Background: Stroke is a leading cause of mortality and morbidity in both developed as well as developing countries The risk factors in lacunar stroke differ in comparison to nonlacunar strokes. In this study risk factors of lacunar stroke in comparison to non-lacunar were evaluated. Objectives: The aim of the study was to compare the risk factors among lacunar stroke and non-lacunar stroke. Methodology: This comparative study conducted in the department of Medicine and Neurology, Dhaka Medical College Hospital, Dhaka from September 2010 to August 2011. MRI of brain was done in 151 patients above 18 years of age with ischemic stroke and Lacunar stroke was found in 31 patients and non-lacunar stroke was detected in 120 patients. Based on the inclusion and exclusion criteria from them 30 patients with lacunar stroke were selected as Group-A patients and equal number of non-lacunar stroke same ages as group B were compared of. The risk factors of stroke were defined as hypertension, diabetes mellitus, hypercholesterolemia, smoking, history of transient ischemic attack, myocardial infarction, atrial fibrillation and carotid artery stenosis. Results: Out of 151 patients with ischemic stroke non-lacunar stroke was predominant, which was 79.47% and lacunar stroke was 20.52%. The mean age was found 60.9±10.2 years in Group A and 56.2±11.8 years in Group B, which was almost similar between two groups (p>0.05). Male were predominant, which was 63.33% and 76.67% in lacunar and non-lacunar stroke respectively. Male and female ratio was 2.3:1. Regarding the risk factors hypertension was observed most common risk factor among the patients having lacunar and non-lacunar strokes. Hypertension and diabetes mellitus were common in lacunar stroke and myocardial infarction, carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke which were statistically significant (p<0.05) between the both groups. However, the percentage of smoking, previous TIA and atrial fibrillation were not significantly (p>0.05) different between lacunar and non-lacunar stroke. Conclusion: Hypertension and diabetes mellitus were common in lacunar stroke, and myocardial infarction, whereas carotid artery stenosis and hypercholesterolemia were common in non-lacunar stroke and the both groups were statistically significant (p<0.05) . So modification of risk factors may reduce the incidence of ischemic stroke. DOI: http://dx.doi.org/10.3329/bjn.v28i2.17176 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 88-95

scholarly journals Comparison of Mid-, and Late- Term Morbidity and Mortality Results of Surgical Endarterectomy Versus Endovascular Stent Implantation in Carotid Artery Stenosis

2021 ◽  
Author(s):  
İsmail Selçuk ◽  
Nehir Selçuk ◽  
Murat Fatih Can ◽  
Ahmet Turan Yılmaz
Keyword(s):  
Carotid Artery ◽  
Stent Implantation ◽  
Carotid Artery Stenosis ◽  
Laboratory Data ◽  
Neurological Complications ◽  
Artery Stenosis ◽  
Morbidity And Mortality ◽  
Endovascular Stent ◽  
Group A ◽  
Group B

Objective: Carotid artery stenosis is an important etiological cause of cerebrovascular events and stent implantation is widely used as an alternative treatment to endarterectomy. In this study, we compared the mid and late-term results of carotid artery stenosis patients who underwent endarterectomy and stent implantation. Methods: Patients who underwent endarterectomy (Group A, n: 27) and endovascular stent implantation (Group B, n: 22) due to carotid artery stenosis between 2008 and 2014 were included in the study. All examination, laboratory data and radiological images were collected from the hospital database. Morbidity and mortality developed in the mid (1-12 months) and late term (>12 months) periods were evaluated retrospectively. Results: While there were no neurological complications and restenosis in the midterm in Group A, 2 patients (9.09%) had stroke and 2 patients (9.09%) had restenosis in Group B. In the late-term, while there were no neurological complications in Group A, stroke in 3 patients (13.63%) (p=0.048) in Group B, restenosis was observed in 1 patient in Group A and 5 patients in Group B (3.7% vs 22.72%, p=0.043). Conclusion: We recommend endarterectomy as the primary approach for carotid artery revascularization and percutaneous approach especially in high-risk patients with recurrent ICA stenosis and distal carotid artery lesions.

scholarly journals Duplex Study of Carotid Artery in Patients with Ischemic Stroke

2013 ◽  
Vol 28 (2) ◽  
pp. 67-73
Author(s):  
Nasreen Sultana ◽  
AKM Faslul Bari ◽  
Touhidul Karim Majumder ◽  
Md Rafiqul Islam ◽  
Ferdous Ara Hossain
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Total Occlusion ◽  
Ischemic Lesion ◽  
Significant Stenosis

Objective: To determine the frequency and characteristics of carotid artery stenosis in acute ischemic stroke patients and to assess the significance of common risk factors for carotid stenosis in these patients. Method: It was cross-sectional observational study which was carried out in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of January 2010 to December 2011 and one hundred patients admitted with acute ischemic stroke were included in the study. Doppler ultrasound was performed during hospitalization to find out carotid artery stenosis. Statistics analysis was done with SPSS - 14. Results: Out of one hundred (100) patients, eighty (80%) were males and twenty were (20%) were females. The patients were dividing into two groups with and without carotid stenosis. Less than 50% carotid artery stenosis (insignificant stenosis) was seen in 40% ( n=40) cases and significant stenosis was seen in 60% (n=60) patients. Overall 86% (n= 46) out of 60 patients were found to have carotid artery stenosis on the ipsilateral side corresponding to the ischemic lesion and 19% (n=11) had stenosis on the contralateral side. Out of significant stenosis ,mild (50% stenosis) in 12% (n=7) patients, moderate ( 51-69% ) stenosis in 50%( n= 30 ) patients and severe (>70%) stenosis in twenty (n=33%) patients . Near total occlusion was seen in three (5%) patients. The presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. Conclusion: Carotid artery stenosis is strongly associated with ischemic stroke. Doppler studies are recommended for the high risk patients for the primary as well as secondary prevention of ischemic stroke.DOI: http://dx.doi.org/10.3329/bjn.v28i2.17172 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 67-73

Risk factors and outcome of patients with carotid artery stenosis presenting with lacunar stroke

Neurology ◽  
2000 ◽  
Vol 54 (3) ◽  
pp. 660-660 ◽  
Author(s):  
D. Inzitari ◽  
M. Eliasziw ◽  
B. L. Sharpe ◽  
A. J. Fox ◽  
H. J. M. Barnett
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Lacunar Stroke

Screening tool for extracranial carotid lesions detection in patients of outpatient vascular clinic

2019 ◽  
Vol 91 (5) ◽  
pp. 1-5
Author(s):  
Piotr Każmierski ◽  
Michał Pająk ◽  
Justyna Kruś-Hadała ◽  
Mateusz Jęckowski ◽  
Katarzyna Bogusiak
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Arteries ◽  
Artery Occlusion ◽  
Artery Stenosis ◽  
Asymptomatic Group ◽  
Symptomatic Carotid ◽  
Atherosclerotic Lesions ◽  
Group A

Purpose The objective of the study was to evaluate the frequency and severity of atherosclerotic lesions in extracranial sections of carotid arteries and to determine the level of the correlation between these lesions and symptoms of cerebral ischemia. Secondly, to identify the most common risk factors of ischaemic stroke occurrence in population of patients of vascular outpatient clinic. Material and Methods Prospective study was conducted on a group of 1,000 people (217 women and 783 men), aged 50 to 86 years, the average age was 62 years (± 9.95). Results Atherosclerotic lesions of carotid arteries were observed in 670 examined people (67%). In 63 cases (6.3%) carotid artery occlusion was revealed. Patients with symptomatic carotid artery stenosis more frequently were addicted to cigarettes and suffered from hypertension in comparison to asymptomatic group. A statistically significant correlation between the TIA or ischemic stroke and smoking were noticed, as well as between TIA/ischemic stroke and hypertension Conclusions Among patients with atherosclerosis of peripheral arteries atherosclerotic lesions in the extracranial carotid sections occur with a high frequency. Statistically significant differences in the incidence and severity of atherosclerotic lesions in the carotid arteries were observed in this group. A statistically significant correlation was revealed between the prevalence and severity of atherosclerosis in the carotid arteries in symptomatic patients and smoking and hypertension. Performing screening in patients with atherosclerosis of the abdominal aorta and/or lower limb arteries may detect significant carotid artery stenosis, requiring surgical intervention.

Abstract TMP33: High Intensity Signal in the Plaque on 3DTOF MRA is Associated With Ischemic Stroke in the Patients With Low Grade Carotid Artery Stenosis

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Kiyofumi Yamada ◽  
Masanori Kawasaki ◽  
Shigehiro Nakahara ◽  
Yoshikazu Sato ◽  
Kazutaka Uchida ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
High Intensity ◽  
Odds Ratio ◽  
Artery Stenosis ◽  
Low Grade ◽  
Carotid Plaques ◽  
Tof Mra ◽  
High Intensity Signal

Background: Carotid artery stenosis is one of the major causes of ischemic strokes. However, degree of stenosis is not always correlated with frequency of ischemic strokes. Recently, it was reported that carotid intraplaque hemorrhage (IPH) was associated with accelerated plaque growth, luminal narrowing and development of symptomatic events. Maximum intensity projection (MIP) images are easily reformatted within from 5 minute, routine time-of-flight (TOF) sequences. The aim of this study was to evaluate the relationships between high intensity signal (HIS) in the carotid plaques on MIP images detected by routine three-dimensional TOF magnetic resonance angiography (3D-TOF MRA) and ischemic strokes. Materials and Methods: One hundred fifty two patients with low-grade carotid artery stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria: 30% - 49%) were included. IPH was defined as the presence of HIS in the carotid plaques on MIP images of 3D-TOF MRA using the previously reported criteria. We analyzed the relationship between the presence of HIS in the plaques and prior ischemic strokes defined as ischemic lesions on diffusion weighed images of the brain. Results: HIS in the carotid plaque was present in 56 (37%) of 152 carotid arteries. Prior ipsilateral ischemic strokes were observed more frequently in HIS-positive group (12 of 56, 21.4%) than HIS-negative group (1 of 34: 2.9%) [p<0.001]. In multivariate logistic regression analysis, HIS (Odds ratio: 77.7, 95%CI: 6.4 - 944.0, p<0.001) and diabetes mellitus type 2 (odds ratio: 10.45, 95%CI: 1.6 - 67.9, p=0.014) were independent determinants of prior ischemic strokes after adjustment for age. Conclusions: HIS in the carotid plaques on MIP images of 3D-TOF MRA was an independent determinant of prior ischemic stroke in patients with low-grade carotid artery stenosis, and this finding may provide a reliable risk stratification of future stroke in patients with low-grade carotid artery stenosis.

Prevalence and risk factors of asymptomatic carotid artery stenosis in Indian population: An 8-year follow-up study

2017 ◽  
Vol 65 (2) ◽  
pp. 279 ◽  
Author(s):  
Subhash Kaul ◽  
Suvarna Alladi ◽  
KRukmini Mridula ◽  
V C SSrinivasarao Bandaru ◽  
Matapathi Umamashesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Indian Population ◽  
Artery Stenosis ◽  
Asymptomatic Carotid ◽  
Follow Up Study ◽  
Asymptomatic Carotid Artery Stenosis

scholarly journals Carotid Endarterectomy Versus Stenting: A Meta-Analysis of Randomized Trials

2011 ◽  
Vol 38 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Daniel Yavin ◽  
Derek J. Roberts ◽  
Michael Tso ◽  
Garnette R. Sutherland ◽  
Misha Eliasziw ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Meta Analysis ◽  
Artery Stenosis ◽  
Cranial Neuropathy ◽  
Cardiac Complications ◽  
Lower Odds

Background:A meta-analysis of randomized controlled trials (RCTs) was conducted to update the available evidence on the safety and efficacy of carotid endarterectomy (CEA) versus carotid artery stenting (CAS) in the treatment of carotid artery stenosis.Methods:A comprehensive search was performed of MEDLINE, EMBASE, CENTRAL, bibliographies of included articles and past systematic reviews, and abstract lists of recent scientific conferences. For each reported outcome, a Mantel-Haenszel random-effects model was used to calculate odds ratios (ORs) and 95% confidence intervals (CI). The I2 statistic was used as a measure of heterogeneity.Results:Twelve RCTs enrolling 6,973 patients were included in the meta-analysis. Carotid artery stenting was associated with a significantly greater odds of periprocedural stroke (OR 1.72, 95% CI 1.20 to 2.47) and a significantly lower odds of periprocedural myocardial infarction (OR 0.47, 95% CI 0.29 to 0.78) and cranial neuropathy (OR 0.08, 95% CI, 0.04 to 0.16). The odds of periprocedural death (OR 1.11, 95% CI 0.56 to 2.18), target vessel restenosis (OR 1.95, 95% CI 0.63 to 6.06), and access-related hematoma were similar following either intervention (OR 0.60, 95% CI 0.30 to 1.21).Conclusions:In comparison with CEA, CAS is associated with a greater odds of stroke and a lower odds of myocardial infarction. While the results our meta-analysis support the continued use of CEA as the standard of care in the treatment of carotid artery stenosis, CAS is a viable alternative in patients at elevated risk of cardiac complications.

Long-term results of carotid stenting and risk factors in patients with severe carotid artery stenosis undergoing subsequent cardiac surgery

2018 ◽  
Vol 93 (3) ◽  
pp. E134-E139 ◽  
Author(s):  
Najibullah Habib ◽  
Bakhtawar K. Mahmoodi ◽  
Maarten J. Suttorp ◽  
Johannes C. Kelder ◽  
Selma C. Tromp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Stenting ◽  
Artery Stenosis ◽  
Long Term Results
Sign in / Sign up

Export Citation Format

Share Document