Neurologia i neurochirurgia polska · 2003
[Prevalence of carotid arteries atherosclerotic changes in ischemic stroke patients].
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Nowaczenko Marek, Sarzyńska-Długosz Iwona, Członkowska Anna
Аннотация
UNLABELLED: The aim of our study was to investigate prevalence, characteristics and extensiveness of CA plaques in acute stroke using high-resolution B-mode USG.
METHODS: USG of CA was performed with a 7.0-MHz Duplex-type scanner Acuson 128 XP/10 C. We examined 149 patients aged 26-95 years, with acute ischemic stroke, consecutively admitted to our Department. Atheromatous plaques morphology was determined using the HSP Classification (H--Hemodynamic characteristics, S--Surface plaque, P--Plaque echogenics).
RESULTS: An extracranial carotid disease (CCA, ICA, ECA) was found in 85 (57%) patients, while 67 (45%) patients had atheromatous changes in ICA. Bilateral ICA plaques were found in 22 (15%) patients, and unilateral--in 45 (30%) patients. In 17 (11%) patients plaques were associated with artery occlusion (in 16 cases ipsilateral to the stroke site, and in 1 case--contralateral). No bilateral occlusion of ICA was observed. In 6 (4%) patients stenosis (ranging from 60 to 99%) was found in only one ICA, while in 4 (2.7%) cases there was also contralateral stenosis < 60%. In 4 patients a contralateral occlusion was present. Ulcerated plaques were noted in 22 (15%) patients--in 18 cases ipsilateral to the stroke, and in the remaining 4--contralaterally. None of the patients had a bilateral ulceration.
CONCLUSION: Atheromatous ICA changes were found in 45% of the patients under study. However, these plaques may be the cause of cerebral ischemia associated with a high-grade stenosis, occlusion or ulceration ipsilateral to the stroke site in 15.45% of the patients only.
METHODS: USG of CA was performed with a 7.0-MHz Duplex-type scanner Acuson 128 XP/10 C. We examined 149 patients aged 26-95 years, with acute ischemic stroke, consecutively admitted to our Department. Atheromatous plaques morphology was determined using the HSP Classification (H--Hemodynamic characteristics, S--Surface plaque, P--Plaque echogenics).
RESULTS: An extracranial carotid disease (CCA, ICA, ECA) was found in 85 (57%) patients, while 67 (45%) patients had atheromatous changes in ICA. Bilateral ICA plaques were found in 22 (15%) patients, and unilateral--in 45 (30%) patients. In 17 (11%) patients plaques were associated with artery occlusion (in 16 cases ipsilateral to the stroke site, and in 1 case--contralateral). No bilateral occlusion of ICA was observed. In 6 (4%) patients stenosis (ranging from 60 to 99%) was found in only one ICA, while in 4 (2.7%) cases there was also contralateral stenosis < 60%. In 4 patients a contralateral occlusion was present. Ulcerated plaques were noted in 22 (15%) patients--in 18 cases ipsilateral to the stroke, and in the remaining 4--contralaterally. None of the patients had a bilateral ulceration.
CONCLUSION: Atheromatous ICA changes were found in 45% of the patients under study. However, these plaques may be the cause of cerebral ischemia associated with a high-grade stenosis, occlusion or ulceration ipsilateral to the stroke site in 15.45% of the patients only.