CAROTID ARTERY STENOTIC LESIONS IN PATIENTS WITH ISCHEMIC STROKE: PREVALENCE, SEVERITY AND ASSOCIATED FACTORS
https://doi.org/10.17802/2306-1278-2013-3-12-17
Abstract
Purpose. To study the incidence of carotid artery stenotic lesions of different severity and the associated factors in ischemic stroke patients.
Materials and methods. 694 patients with different subtypes of ischemic stroke treated in the neurology department were enrolled. Color duplex imaging was used as a diagnostic technique. According to the degree of carotid artery disease patients were divided into the following groups: Group I included individuals with no or mild stenoses (up to 30 %), Group II included those with moderate stenotic lesions (30–49 %) and Group III, patients with carotid artery setnoses of 50 % and more. The NIHSS was used to assess the severity of neurologic deficit and ischemic stroke subtype was determined according to the TOAST classification.
Results. Patients with carotid stenoses of 50 % and more had atherothrombotic strokes, risk factors for stroke and severe neurologic deficit unlike those who had no or mild or moderate lesions. Patients with moderate carotid lesions more often had cardioembolic strokes and moderate neurologic deficit while the group with no carotid lesions had hemodynamic strokes and mild or moderate neurologic deficit.
Conclusions. Detecting carotid artery stenotic lesions of different severity allows to find ischemic stroke patients with poor prognosis and a high risk for concomitant coronary artery disease.
About the Authors
A. N. Sumin
Federal State Budgetary Institution Research Institute for Complex Issuesof Cardiovascular Diseases, Siberian Branch of the Russian Academyof Medical Sciences, Kemerovo
Russian Federation
Russian Federation
I. N. Kukhareva
Federal State Budgetary Institution Research Institute for Complex Issuesof Cardiovascular Diseases, Siberian Branch of the Russian Academyof Medical Sciences, Kemerovo
Russian Federation
Russian Federation
O. A. Trubnikova
Federal State Budgetary Institution Research Institute for Complex Issuesof Cardiovascular Diseases, Siberian Branch of the Russian Academyof Medical Sciences, Kemerovo
Russian Federation
Russian Federation
A. V. Kovalenko
Federal State Budgetary Institution Research Institute for Complex Issuesof Cardiovascular Diseases, Siberian Branch of the Russian Academyof Medical Sciences, Kemerovo
Russian Federation
Russian Federation
References
1. Каротидная эндартерэктомия или каротидное стентирование: выбор оптимального метода лечения больных со стенозами сонных артерий / А. В. Гавриленко [и др.] // Ангиология и сосудистая хирургия. 2011. № 2. С. 70–77.
2. Окружающая среда как фактор риска развития ишемической болезни сердца в урбанизованном регионе с развитой химической промышленностью / Г. В. Артамонова [и др.] // Кардиология. 2012. № 10. С. 86–90.
3. Роль клинической оценки и коронароангиографии в снижении числа кардиальных осложнений при сосудистых операциях промежуточного и высокого риска / Л. С. Барбараш [и др.] // Ангиология и сосудистая хирургия. 2012. № 4. С. 33–41.
4. Семенова В. В., Закирова А. Н. Гемодинамически незначимые стенозы сонных артерий и риск развития эмбологенных инсультов у больных ишемической болезнью сердца // Рациональная фармакотерапия в кардиологии. 2009. № 3. С. 62–66.
5. Суслина З. А., Варакин Ю. Я., Верещагин Н. В. Сосудистые заболевания головного мозга. М.: МЕДпресс-информ, 2009. 219 с.
6. Фокин А. А., Бельская Г. Н., Файзуллин К. Р. Диагностика стенозирующей патологии сонных артерий у лиц, перенесших транзиторную ишемическую атаку: две стороны одной проблемы // Медицинский вестник Башкортостана. 2011. № 6. С. 62–66.
7. 2 year results of the vascular imaging of acute stroke for identifying predictors of clinical outcome and recurrent ischemic eveNts (VISION) study / S. B. Coutts [et al.] // BMC Cardiovasc. Disord. 2011. Vol. 23. P. 11–18.
8. Carotid stenosis as predictor of stroke after transient ischemic attacks / D. M. Bonifati [et al.] // J. Neurol. Sci. 2011. Vol. 303 (1–2). P. 85–89.
9. Common carotid intima media thickness as a marker of clinical severity in patients with symptomatic extracranial carotid artery stenosis / I. Heliopoulos [et al.] // Clin. Neurol. Neurosurg. 2009. Vol. 111 (3). P. 246–250.
10. Effect of carotid stenosis on the prognostic value of admission blood pressure in patients with acute ischemic stroke / M. Paciaroni [et al.] // Atherosclerosis. 2009. Vol. 206 (2). P. 469–473.
11. High risk of early neurological recurrence in symptomatic carotid stenosis / A. Ois [et al.] // Stroke. 2009. Vol. 40 (8). P. 2727–2731.
12. Investigators of the Registry of the Canadian Stroke Network. Short-term outcomes after symptomatic internal carotid artery occlusion / M. J. Burke [et al.] // Stroke. 2011. Vol. 42 (9). P. 2419–2424.
13. Jeong S. K., Seo J. Y., Cho Y. I. Homocysteine and internal carotid artery occlusion in ischemic stroke // J. Atheroscler. Thromb. 2010. Vol. 17 (9). P. 63–69.
14. King A., Shipley M., Markus H. Оптимизированные протоколы прогнозирования риска при бессимптомном стенозе сонных артерий с использованием регистрации сигнала. Исследование Asymptomatic Carotid Emboli Study // Stroke. 2012. № 2. С. 37–44.
15. Kleindorfer D., Lindsell C. J., Brass L. National US Estimates of Recombinant Tissue Plasminogen Activator Use // Stroke. 2008. Vol. 39. P. 924–928.
16. Lipoprotein (a) and carotid atherosclerosis in young patients with stroke / N. Nasr [et al.] // Stroke. 2011. Vol. 42 (12). P. 3616–3618.
17. Mead G. E., O'Neill P. A. Carotid disease in acute stroke: a review // J. Stroke. Cerebrovasc. Dis. 1999. Vol. 8 (4). P. 197–206.
Review
For citations:
Sumin A.N., Kukhareva I.N., Trubnikova O.A., Kovalenko A.V. CAROTID ARTERY STENOTIC LESIONS IN PATIENTS WITH ISCHEMIC STROKE: PREVALENCE, SEVERITY AND ASSOCIATED FACTORS. Complex Issues of Cardiovascular Diseases. 2013;(3):12-17. (In Russ.) https://doi.org/10.17802/2306-1278-2013-3-12-17
Views:
464
