Purpose
Ischemic stroke is responsible for 10% of all deaths and is the second cause of mortality worldwide; however,
stroke is the leading cause of mortality in China and Japan (1).Carotid artery stenosis represents a major risk factor for stroke and transient ischemic attack (TIA) and it can determine approximately up to 25% of strokes (2).
Histologic studies have shown differences between symptomatic and asymptomatic carotid plaques (3) and,
consequently,
carotid plaque evaluation has been focused on the identification of high risk carotid plaque patterns,
as...
Methods and Materials
Patient selection and diagnosis.
Between January 2008 and December 2009,
102 patients (M/F 68/34) were referred to our institution for minor stroke or transient ischemic attack (TIA)risenup toonemonthbefore.The institutional review board at our institution gave full approval and waiver of informed consent for our retrospective study and approved our treatment protocol.Allpatientsenrolled wereat highsurgical risk.
At the hospitalization,
patients underwent epiaortic vessels duplex ultrasound imaging (DUI) and magnetic resonance (MR) scan of the brain.Neurologic symptoms were assessed by a neurologist,
who decided if patients should be...
Results
Before the procedure all patients were matched following the criteria present in table I and divided in two different grous.
In group 1 characterized by 19 patients with hyperintense plaque on after-contrast T1-weighted images,
12 stenoses (63.1 %) were located in the right internal carotid artery,
7 (37.9 %) in the left internal carotid artery.
The degree of stenosis averaged 67 ± 6%,
in particular stenoses >70%were found in 10 patients (52.6%) and stenoses averaged from 50 to 70% were found in 9 patients (47.4%)....
Conclusion
Ischemic stroke is responsible for 10% of all deaths and is the second cause of mortality worldwide.
Carotid artery stenosis is the major risk factor for this disease (1).
The degree of luminal stenosis has been used for years as a marker of atherosclerotic stage,
and as an indication for surgical or endovascular intervention (6).
However several studies have underlined the importance of broadening the horizons of stenosis criteria: in this respect clinical trials have shown that a considerable population of patients which are symptomatic...
References
Sacco RL,
Adams R,
Albers G Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack.
Stroke 2006;37:577–617
Adams HP Jr,
Bendixenn BH,
Kappelle LJ,
et al.
.
Classification of subtype of acute ischemic stroke.
Definitions for use in a multicenter clinical trial.
TOAST trial of Org 10172 in acute stroke treatment.
Stroke 1993; 24(1):35-41;
Fisher M,
Paganini-Hill A,
Martin A,
et al.
Carotid plaque pathology: thrombosis,
ulceration,
and stroke pathogenesis.
Stroke 2005; 36:253–7.
Langlois YE,
Roederer GO,
Chan AT,
et...