The Presence of Carotid Stenosis in Patients with Acute Ischemic Stroke

Cilj istraživanja: Ispitati zastupljenost bolesnika koji imaju karotidnu aterosklerotsku bolest, zastupljenost glavnih čimbenika rizika za moždani udar te ispitati vrstu i stupanj aterosklerotskih stenotskih promjena u različitim podvrstama akutnog ishemijskog moždanog udara (IMU). Nacrt studije: studija je bila presječena povijesnim podatcima. Ispitanici i metode: Ispitalo se 100 bolesnika s akutnim IMU-om. Bilježili su se podatci o dobi i spolu bolesnika, podatci o glavnim čimbenicima rizika za nastanak akutnog IMU-a, podatci o podvrsti IMU-a prema The Trial of Org 10172 in Acute Stroke Treatment klasifikaciji te su se bilježili nalazi color dopplera karotidnih i vertebralnih arterija. Rezultati: Istraživanje pokazuje visok udjel karotidne aterosklerotske bolesti (97 %) u bolesnika s akutnim IMU-om. Stenoza karotidne arterije bila je zastupljena u 62 % ispitanika, od čega je najveći broj imao početnu stenozu, a najmanja je bila zastupljenost hemodinamski značajne stenoze. Najviša zastupljenost karotidne stenoze i okluzije bila je u bolesnika s IMU-om velikih krvnih žila, a lakši stupanj aterosklerotske bolesti (plakovi i početna stenoza) u bolesnika s IMU-om malih krvnih žila i kardioembolijskom IMU-om. U bolesnika s hiperlipidemijom pronađena je povećana učestalost mješovitih te nešto manja tvrdih aterosklerotskih plakova. Zaključak: Provedeno istraživanje pokazuje izrazito visoku zastupljenost karotidne stenoze i aterosklerotskih plakova u bolesnika s akutnim IMU-om, daje korisne informacije o etiopatogenezi i patofiziologiji ove bolesti i ukazuje na važnost color dopplera karotidnih arterija u liječenju i prevenciji IMU-a.Objective: The aim of the study was to determine the prevalence of carotid artery stenosis, the prevalence of acute ischemic stroke risk factors, and to determine the stage of carotid atherosclerosis in stroke subtypes in acute ischemic stroke patients. Study design: The study was designed as a cross sectional study with data extracted from patients’ history. Participants and methods: The study included 100 patients suffering from acute ischemic stroke. The data observed included age, sex, and risk factors for stroke. Stroke subtype was identified by The Trial of Org 10172 in Acute Stroke Treatment classification. Color Doppler evaluation of carotid and vertebral artery were recorded as well. Results: The study indicated high prevalence of carotid atherosclerotic disease (97 %) in patients with acute ischemic stroke. Carotid artery stenosis was found in 62 % of the patients. Mild stenosis was the most common, while severe stenosis was the least prevalent. Patients with large-artery atherosclerosis displayed highest prevalence of carotid stenosis and occlusion, while patients with cardioembolism and small-artery occlusion had highest prevalence of initial stage of carotid atherosclerotic disease. Positive correlation was found between hyperlipidemia and echogenic and calcified atherosclerotic plaques. Conclusion: Conducted study leads to better understanding of etiology and pathophysiology of acute ischemic stroke and emphasizes the importance of color Doppler evaluation of carotid and vertebral arteries in acute ischemic stroke patients and in stroke prevention