Duplex Study of Carotid Artery in Patients with Ischemic Stroke

Abstract

Objective: To determine the frequency and characteristics of carotid artery stenosis in acute ischemic stroke patients and to assess the significance of common risk factors for carotid stenosis in these patients. Method: It was cross-sectional observational study which was carried out in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during the period of January 2010 to December 2011 and one hundred patients admitted with acute ischemic stroke were included in the study. Doppler ultrasound was performed during hospitalization to find out carotid artery stenosis. Statistics analysis was done with SPSS - 14. Results: Out of one hundred (100) patients, eighty (80%) were males and twenty were (20%) were females. The patients were dividing into two groups with and without carotid stenosis. Less than 50% carotid artery stenosis (insignificant stenosis) was seen in 40% ( n=40) cases and significant stenosis was seen in 60% (n=60) patients. Overall 86% (n= 46) out of 60 patients were found to have carotid artery stenosis on the ipsilateral side corresponding to the ischemic lesion and 19% (n=11) had stenosis on the contralateral side. Out of significant stenosis ,mild (50% stenosis) in 12% (n=7) patients, moderate ( 51-69% ) stenosis in 50%( n= 30 ) patients and severe (>70%) stenosis in twenty (n=33%) patients . Near total occlusion was seen in three (5%) patients. The presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. Conclusion: Carotid artery stenosis is strongly associated with ischemic stroke. Doppler studies are recommended for the high risk patients for the primary as well as secondary prevention of ischemic stroke.DOI: http://dx.doi.org/10.3329/bjn.v28i2.17172 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 67-73

Assessment of carotid arteries in stroke patients by ultrasonography and color Doppler

“…Similar to current study findings report published by Nasreen et al and Sethi et al revealed majority of patients with carotid artery atherosclerosis (56%) of more than 60 years of age with mean age of 60.03 years. 25,26 Gender based distribution of carotid artery atherosclerosis patients reported by Malik et al stated 64% males and 36% females, also the authors reported none of the premenopausal females had lesion and approximately 40% of postmenopausal females had abnormal carotid Doppler which was in close accordance to current study observations. 27 Hemiparesis was observed as the most common clinical presentation in the present study followed by cranial nerve palsies, aphasia and monoparesis, the findings were similar to reports published by Malik et al who reported hemiparesis in majority (76%) of patients.…”

“…27 Sultana et al reported distribution of degree of stenosis was mild (50%) in 12% of patients, moderate (51-69%) in 50% of patients and severe (>70%) in 20% of patients and near-total occlusion were seen in three (5%) patients also they reported that the presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. 25 Sultana et al reported distribution of degree of stenosis was mild (50%) in 12% of patients, moderate (51-69%) in 50% of patients and severe (>70%) in 20% of patients and near-total occlusion were seen in three (5%) patients also they reported that the presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. 25 These reported findings were in close accordance to current study observations.…”

“…25 Sultana et al reported distribution of degree of stenosis was mild (50%) in 12% of patients, moderate (51-69%) in 50% of patients and severe (>70%) in 20% of patients and near-total occlusion were seen in three (5%) patients also they reported that the presence of stenosis was significantly correlated with older age and the presence of multiple risk factors. 25 These reported findings were in close accordance to current study observations.…”

Incidence of Carotid Atherosclerosis in Ischemic Stroke Detected by Duplex Ultrasound

“…According to degree of carotid artery stenosis: Significant carotid artery stenosis: ≥ 50%, and insignificant carotid artery stenosis: < 50% (8) .…”