Doppler sonographic assessment of carotid arteries in Sudanese stroke patients

Tagelsir, Sarah; Gameraddin, Moawia; Babiker, Mahmoud S.; Gareeballah, Awadia; Abdelmaboud, Suzan; Salih, Suliman

doi:10.4103/bc.bc_5_17

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…We have found significantly higher values of RI and PI in the left ICA of the older patients. The association between aging and carotid atherosclerosis was also found in previous studies [6,27,28]. Smoking history was found to have a significant association with left CCA RI and PI values.…”

Section: Discussionsupporting

confidence: 83%

“…It assesses intima-media thickness (IMT), stenosis, plaques, and other lumen and wall alterations. This is a safe, affordable, reliable, repeatable, and convenient method to detect carotid atherosclerosis [5,6]. The thickness between the intimal-luminal and the medial-adventitial interfaces is defined as the IMT or carotid intima-media thickness (CIMT) [7].…”

Section: Introductionmentioning

confidence: 99%

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The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Kawnayn¹,

Kabir²,

Huq³

et al. 2023

Cureus

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Background: Carotid atherosclerosis is an important etiological factor for ischemic stroke. Early carotid lesion detection may prevent further strokes. Doppler ultrasound measures carotid artery blood flow, intimamedia thickness, stenosis, plaques, and lumen and wall changes.Objective: The objective of this study is to determine the association of carotid plaque size (CPS), carotid intima-media thickness (CIMT), resistive index (RI), and pulsatility index (PI) with acute ischemic stroke.Methodology: A total of 60 participants were taken, including 30 cases and 30 age-and sex-matched controls. Patients with acute ischemic stroke were included as cases and age-and sex-matched healthy volunteers were included as controls. A carotid duplex study was done in both groups, and the findings were compared.Results: The mean age of the ischemic stroke cases was 63.33±10.79 years; more than half were aged >60 years. Male patients were 73.3% and female patients were 26.7% of the cases. Age and gender were statistically similar (p>0.05) in groups (cases and controls). The plaques were homogenous in 30% of patients, calcified in 26.7%, and mixed in 6.7%. About 36.6% of patients did not have any plaque. CPS was greater among cases than controls in the right and left internal and left common carotid arteries; however, it was not statistically significant (p>0.05). The mean CIMT was 0.79±0.10 mm on the right side and 0.90±0.17 mm on the left side among cases. CIMT was significantly higher in the cases group than in the controls (p<0.05). The mean RI was significantly greater in the left common carotid artery (CCA) among the cases than in the controls (p<0.05). Patients aged over 60 years had significantly higher RI and PI values in the left internal carotid artery (ICA) compared to the younger cases (p<0.05). Smoking history had a significant association with left CCA RI and PI values (p<0.05). However, RI, PI, CPS, and CIMT among cases were similar in different groups like diabetic, non-diabetic, hypertensive, and non-hypertensive patients (p>0.05).Conclusion: CIMT was significantly thicker among the patients with ischemic stroke compared to the control group. RI in the left CCA was significantly greater among the stroke patients than in the control group. The age of the patient and smoking habit had an association with RI and PI values. Most of the parameters were found to be significant on the left side, suggesting carotid atherosclerosis may not be symmetrical. A largescale further study is needed to see the association of these variables with ischemic stroke patients.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Kawnayn¹,

Kabir²,

Huq³

et al. 2023

Cureus

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“…found a significant increase in RI on carotid Doppler study in fifty Sudanese patients with acute stroke. [ 16 ] Similarly, Staub et al ., in a prospective study of 146 patients with cardiovascular risk factors followed up for a median 36 months, showed a direct correlation between RI and intima–media thickness (IMT) of the CCA and ICA and cardiovascular and cerebrovascular events in these patients. [ 28 ] They concluded that like IMT, RI is an indicator of the vessel wall status and can be a predictive marker of stroke.…”

Section: Discussionmentioning

confidence: 96%

“…[ 27 ] RI relates to elasticity or extensibility of the vessel and its related vascular resistance. [ 16 ] Tagelsir et al . found a significant increase in RI on carotid Doppler study in fifty Sudanese patients with acute stroke.…”

Section: Discussionmentioning

confidence: 99%

“…[ 13 ] PI assesses vascular resistance and is considered a marker of small vessel disease and microangiopathic changes in the brain, [ 14 , 15 ] whereas RI relates to the vessel wall elasticity. [ 16 ] The normal values for PI and RI are typically <1.2 and <0.7, respectively. [ 17 ] Assessment of PSV, PI, and RI can provide important information for making therapeutic decisions and help as a prognostic tool in predicting functional outcomes in patients of ischemic stroke or after carotid interventions.…”

Section: Introductionmentioning

confidence: 99%

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Sequential carotid Doppler study in acute stroke and its clinical correlation: A prospective study

Karn,

Narayan,

Qavi

et al. 2023

JNRP

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Objectives: Resistive index (RI) and pulsatility index (PI) assessed on carotid Doppler assess the hemodynamic status of cranial vasculature. They are related to the severity of stroke and help determine the overall outcome. This study was done to compare the hospital stay and stroke severity with RI and PI of both internal carotid arteries. Materials and Methods: Patients >18 years of age presenting within 48 h of anterior circulation stroke (either ischemic or hemorrhagic) were included. They were divided into two groups based on their length of stay (LOS). They were assessed clinically on days 1, 3, and 5, and underwent a carotid Doppler study on the same days. The Doppler parameters were correlated with the LOS and stroke severity for possible associations. Results: One hundred and one patients were included. Forty-seven patients had a favorable outcome based on LOS. In this group, significant decrease in RI and PI scores was seen from days 1 to 3. In patients with unfavorable outcome, there was a significant increase in PI on days 1–3 and days 1–5. The National Institutes of Health Stroke Scale decreased significantly from days 1 to 5 in favorable group Conclusion: For those with an unfavorable outcome and prolonged LOS, PI continues to increase suggesting a failure of autoregulation. Carotid Doppler can be a simple bedside tool to predict outcome in patients with acute stroke.

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Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease

Zheng

Qian

Lin

et al. 2020

Therapeutic Advances in Chronic Disease

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Background: Carotid intima–media thickness (cIMT) is considered a risk factor for and predictor of cerebrovascular disease. In this study, we explored the contribution of cIMT to cognitive impairment (CI) in dialysis patients and the role of cerebral small vascular disease (CSVD) and brain atrophy in this process. Methods: Cognitive function was assessed using a comprehensive cognitive test battery. CSVD and brain volume were assessed by magnetic resonance imaging, and cIMT was measured by ultrasonography. Multivariable analysis and mediation were used to explore the relevant relationships among cIMT, CI, CSVD and brain volume. Results: Seventy-three dialysis patients were enrolled. Approximately 54.8% were diagnosed with increased cIMT. The increased cIMT group was older and had lower serum albumin and creatinine levels than the normal cIMT group. There was no difference in the CSVD prevalence between the different cIMT groups. Patients in the normal, unilaterally and bilaterally increased cIMT subgroups demonstrated a gradual decrease in brain-matter volume and degenerate cognitive function. cIMT was related to cognitive function and gray-/white-matter volume. Increased cIMT was associated with a significantly increased risk of a reduced Mini Mental State Examination/Montreal Cognitive Assessment score and Trail A/B time delay. Mediation analysis showed that CI was mediated by brain-matter volume but not by CSVD. Conclusion: Increased cIMT was an independent risk factor for impairment of global cognitive function, memory, and executive function. The impact of cIMT on cognition was not induced by CSVD but by brain atrophy. cIMT may be a useful tool for screening patients at high risk of CI in the dialysis population.

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Doppler sonographic assessment of carotid arteries in Sudanese stroke patients

Cited by 7 publications

References 17 publications

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Sequential carotid Doppler study in acute stroke and its clinical correlation: A prospective study

Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease

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