Association of Cigarette Smoking with Thickness of Intimal Layer of Carotid Arteries on Color Doppler Ultrasound Study and Its Surgical Management

Abstract

Objectives: Aim of this study is to evaluate the intimal vessel wall thickness in smoker and their co-relation with non-smoker and also surgical management of stenosis.
 Material and Methods: It is a prospective study of 55 cases. Study span and follow up duration were 4 months. Our patients were presented with the history of CVA (Cerebrovascular accident), hypertension, diabetes, and headache.
 Results: In all patients, the carotid doppler ultrasound was done and their intimal vessel wall thickness was noted. Our 78% patients were smoker and non-smoker was 22%. In our study, 52% patients had CVA, 41% patients had hypertension, 30% patients had headache and 9% patients were also obese. Forty three smokers used to take 15 – 25 cigarettes daily. Among 43 patients, 5 patients were females. In carotid Doppler study, intimal thickness was increased in 87%, the plaque was observed in 49% and stenosis was observed in 38% cases. In 18 % patients, who had stenosis > 70%, carotid endarterectomy was performed and in rest of the patients medical treatment done.Patients who were chronic smokers and had medical co-morbidities showed greater thickness of intimal layer of vessels on carotid Doppler. In 6 patients, post-operative headache occurred.
 Conclusion: Smokers had more thickness of intimal layer of carotid vessels. Carotid endarterectomy yields good results in case of stenosis more than 70%.
 Keywords: Cerebrovascular accident, Intimal layer thickness, Carotid doppler ultrasound, Cigarette smoking