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The CHAT classification of stroke.

E F Bernstein1, N L Browse

  • 1Department of Surgery, Scripps Clinic and Research Foundation, La Jolla, California 92037.

Annals of Surgery
|February 1, 1989
PubMed
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A new classification system for cerebrovascular disease, the CHAT system, improves stroke episode reporting. It reveals significant differences in survival and stroke-free survival after carotid endarterectomy.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Clinical Epidemiology

Background:

  • Current stroke terminology is inconsistent, hindering data inclusion on arterial disease extent and global brain symptoms.
  • Existing classifications lack European alignment and fail to capture hemispheric or global clinical history.
  • Inconsistent terminology complicates comparative analysis and clinical trial design for cerebrovascular disease.

Purpose of the Study:

  • To introduce and validate the Cerebrovascular History and Anatomy Taxonomy (CHAT) classification system.
  • To address limitations in current stroke episode terminology for cerebrovascular disease.
  • To enhance the reporting and analysis of surgical cerebrovascular disease experience.

Main Methods:

  • Development of the CHAT classification system incorporating clinical presentation, history, arterial disease details, and brain abnormalities.

Related Experiment Videos

  • Retrospective review of 480 consecutive carotid endarterectomy cases using the CHAT system.
  • Statistical analysis to compare survival and stroke-free survival probabilities based on presenting conditions and patient history.
  • Main Results:

    • The CHAT classification demonstrated advantages in analyzing carotid endarterectomy data.
    • Significant differences in survival probability were observed for asymptomatic stenosis patients with prior contralateral symptoms.
    • Stroke-free survival varied significantly between patients presenting with amaurosis fugax versus transient ischemic attacks (TIAs).

    Conclusions:

    • The CHAT classification system offers a significant advancement for reporting surgical cerebrovascular disease.
    • CHAT facilitates more precise analysis of patient outcomes after carotid endarterectomy.
    • This classification has implications for ongoing randomized trials comparing medical and surgical treatments for carotid artery disease.