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Carotid disease in acute stroke.
G E Mead1, H Shingler, A Farrell
1Department of Geriatric Medicine, South Manchester University NHS Trust, West Didsbury, UK.
Age and Ageing
|July 17, 1999
Summary
The Oxfordshire Community Stroke Project (OCSP) classification can help identify acute stroke patients with significant carotid artery stenosis. This aids in selecting individuals for carotid imaging and potential surgery, particularly those with partial anterior circulation infarcts (PACI).
Area of Science:
- Neurology
- Vascular Surgery
- Diagnostic Imaging
Background:
- The Oxfordshire Community Stroke Project (OCSP) developed a clinical classification for acute stroke.
- This classification previously predicted mortality, recovery, and recurrent stroke patterns.
Purpose of the Study:
- To evaluate if the OCSP classification could predict carotid artery disease in acute stroke patients.
- To determine if OCSP classification could guide referrals for carotid imaging and endarterectomy.
Main Methods:
- 305 acute stroke patients were classified using the OCSP system.
- Carotid arteries were assessed using portable continuous wave Doppler, followed by colour duplex Doppler imaging for abnormal findings.
Main Results:
- Severe ipsilateral carotid stenosis (70-99%) or occlusion was more frequent in partial anterior circulation infarct (PACI) and total anterior circulation infarct (TACI) groups.
- The OCSP classification showed 76% sensitivity and 70% specificity for detecting 70-99% carotid stenosis.
Conclusions:
- Ipsilateral carotid disease is a significant stroke cause in PACI and TACI, but not lacunar infarct (LACI) or posterior circulation infarct (POCI).
- Patients with PACI should undergo early carotid imaging to identify candidates for carotid surgery.