CT Angiographic Evaluation of Pattern and Distribution of Stenosis and its Association with Risk Factors Among Indian Ischemic Stroke Patients

Abstract

SummaryBackgroundStroke is the major cause of disability and third major cause of death. Ischemia causes about 80% of stroke cases; stenosis and occlusion are the predominant cause of stroke. Our purpose for this study was to evaluate the pattern and distribution of stenosis and its association with risk factors in Indian ischemic stroke patients and in other countries, for comparison.Material/MethodsWe evaluated 60 patients after ischemic stroke with CT angiography. The degree of stenosis was measured by the North American Symptomatic Carotid Endarterectomy Trial (NASCET). The results were analyzed by descriptive statistics and chi-square test.ResultsOut of 60 cases, 32 cases were positive for significant stenosis and a total number of stenotic segments was 45. Out of 45 stenotic segments, 29 were single stenotic segments (16 intracranial and 13 extracranial) and 16 were multiple stenotic segments (8 intracranial and 8 extracranial). In the total number of stenotic segments (single and multiple), there were 24 (53.33%) intracranial and 21 (46.67%) extracranial. The most commonly involved intracranial stenosis segment was MCA, present in 10 (41.6%) out of 24 intracranial segments. Most commonly involved extracranial stenosis segment was ICA, present in 14 (66.6%) out of 21 extracranial segments. Diabetes is found to be the most common risk factor of intracranial stenosis while hypertension and hypercholesterolemia are the major risk factors of extracranial stenosis.ConclusionsIn the Indian population, intracranial stenosis is more common than extracranial one, anterior circulation stenosis is more common than posterior circulation stenosis; single stenosis is more common than multiple stenosis.

MRA evaluation of cerebrovascular stenosis and its association with acute stroke in Indian patients

“…Arterial locations of stenosis: MCA was the predominant location of stenosis (61.1%), followed by PCA (14.8%) in our study, which correlates well with previous observations [9,12]. In MCA,…”

“…Further, we observed that ICS had an earlier onset as it was more common in the < 60 years age group, whereas ECS occurred in the > 60 years group. Two diagnostic studies performed on different subsets of the Indian population also showed higher representation of ICS-MRA anomalies in individuals affected with stroke, which corroborates our findings [8,9]. In addition, we also observed that stenosis predominantly occurred in males than in females.…”

“…Available online at: www.ijmrr.in 676 | P a g e the presence, location, and extent of stenosis in symptomatic and asymptomatic patients with stroke, and this might assist in deciding the mode of treatment [6,7]. Intracranial stenosis (ICS) is predominant among Indian patients and is in contrast to that observed in Caucasian and Oriental patients [8,9]. However, detection of intracranial atherosclerotic disease has been elusive, possibly because of the dearth of non-invasive methods for diagnosing the condition.…”

“…Hypertension is a major risk factor for cerebrovascular diseases [6]. DM is another risk factor for cerebrovascular diseases [8,9]. Transcranial Doppler examination was used to identify stenosis in MCAs in over onefifth of the Chinese type 2 diabetic subjects who had no symptoms of cerebrovascular disease.…”

Clinical and radiological factors predict unexplained early neurological deterioration after intravenous thrombolysis in patients with acute middle cerebral artery stroke

“…1. ) CTA image analysis CTA diagnosis criteria for Internal Carotid Artery (ICA) stenosis: The degree of carotid stenosis was calculated according to the measurement criteria used in the North American Symptomatic Carotid Endarterectomy Trial (NASCET) [19]. Formula: Stenosis rate (%) = (normal ICA diameter in the distal segment -minimum residual diameter in the stenosis segment) / normal ICA diameter in the distal segment × 100%.…”