CAROTID ARTERY STENOSIS AS A RISK FACTOR FOR THE OCCURRENCE OF ISCHEMIC STROKE

Background: Carotid atherosclerotic disease is recognized as an important risk factor for brain ischemic events. However, high-grade stenosis does not always cause ischemic strokes, whereas moderate-grade stenosis may often cause ischemic strokes. It has been reported that there is an association between carotid intraplaque hemorrhage (IPH) and new cerebral ischemic events. The purpose of this study was to elucidate the relationship between high-intensity signals (HIS) on maximum intensity projection (MIP) images from routine 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and prior ischemic strokes in the patients with moderate carotid stenosis. Materials and Methods: Sixty-one patients with moderate carotid artery stenosis (50-69% stenosis based on North American Symptomatic Carotid Endarterectomy Trial criteria) were included. Carotid IPH was defined as the presence of HIS in carotid plaques on MIP images detected by 3D-TOF-MRA using criteria we previously reported. We analyzed the relationship between the presence of HIS in plaques and prior ischemic strokes defined as ischemic lesions on diffusion-weighted brain images. Results: HIS in carotid plaques were present in 27 (44%) of 61 patients. Prior ipsilateral ischemic strokes occurred more frequently in the HIS-positive group than the HIS-negative group (67 vs. 9%, p < 0.001). Furthermore, there were more smokers in the group with ischemic stroke than without it (62 vs. 25%, p = 0.005). In multivariate logistic regression analysis, HIS in carotid plaque (OR 23.4, 95% CI 4.62-118.3, p < 0.001) and smoking (OR 5.44, 95% CI 1.20-24.6, p = 0.028) were independent determinants of prior ischemic strokes after adjustment for age. Conclusions: HIS in carotid plaques on 3D-TOF-MRA MIP images are independent determinants of prior ischemic strokes in patients with moderate carotid artery stenosis, and they can potentially provide a reliable risk stratification of patients with moderate carotid artery stenosis.

Download Full-text

AS-54: Sex as an Independent Risk Factor for Adverse Events following Carotid Stenting for Carotid Artery Stenosis: Acute and Long-Term Follow-Up Results

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.01.099 ◽

2009 ◽

Vol 103 (9) ◽

pp. 25B

Author(s):

Chung-Ho Hsu ◽

Jen-Jyh Lin ◽

Ping-Han Lo ◽

Kuan-Chen Chang ◽

Jui-Sung Hung

Keyword(s):

Risk Factor ◽

Carotid Artery ◽

Adverse Events ◽

Carotid Artery Stenosis ◽

Independent Risk Factor ◽

Carotid Stenting ◽

Artery Stenosis ◽

Long Term Follow Up

Download Full-text

A study on prevalence of carotid artery stenosis in acute ischaemic stroke patients in Amalapuram, Andhra Pradesh, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192489 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2146

Author(s):

Bonthu Mamatha Bharathi ◽

Raveena Gullapalli

Keyword(s):

Risk Factor ◽

Carotid Artery ◽

Ischaemic Stroke ◽

Carotid Stenosis ◽

Carotid Artery Stenosis ◽

Acute Onset ◽

Artery Stenosis ◽

Doppler Study ◽

Diastolic Velocity ◽

Asymptomatic Patients

Background: Extra cranial carotid disease due to arteriosclerosis is usually associated with hypercholesterolemia and hyperlipidemia. Extra cranial carotid stenosis has been found to be less prevalent in black American and in Egyptians while intracranial disease is far more common Various methods includes transcranial doppler (TCD) ultrasonography, cerebral angiography, computed tomography angiography (CTA) and magnetic resonance angiography (MRA).Methods: All patients with ischaemic stroke of acute onset admitted in the medical wards of Konaseema institute of medical sciences between June 2018 and January 2019 were included in the study. All patients were subjected to CT scan brain study and colour Doppler study of extra cranial carotid arteries and vertebral arteries. Systolic and diastolic velocity of blood flow, carotid intimal medial thickness, presence of athermanous plaque and thrombus was looked for and then the percentage of stenosis of the affected arteries was calculated.Results: In the present study 0ut of 23 patients with carotid stenosis 9 patients had mild carotid stenosis, 8 patients had moderate stenosis and 6 patients had severe stenosis. Out of 23 patients with carotid stenosis the 11 patients have stenosis in the right carotid and 12 patients had stenosis in the left side. The site of stenosis is ICA in 17 patients and CCA in 6 patients.Conclusions: In present study every patient with carotid artery stenosis had one or the other risk factor for carotid atherosclerosis. In other words, there was no patient with carotid artery stenosis, without any risk factor in present study. Hence asymptomatic patients with these risk factors should be screened for carotid stenosis to prevent stroke.

Download Full-text

Thyroid function and internal carotid artery stenosis in ischemic stroke

Endocrine Journal ◽

10.1507/endocrj.k10e-135 ◽

2010 ◽

Vol 57 (8) ◽

pp. 711-718 ◽

Cited By ~ 7

Author(s):

Seul-Ki Jeong ◽

Jin-Young Seo ◽

Hae-Sung Nam ◽

Hyeong-Kyu Park

Keyword(s):

Ischemic Stroke ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Thyroid Function ◽

Carotid Artery Stenosis ◽

Internal Carotid ◽

Internal Carotid Artery Stenosis ◽

Artery Stenosis

Download Full-text

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 ◽

10.1161/str.48.suppl_1.tmp33 ◽

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.

Download Full-text