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Carotid Doppler Ultrasound in Stroke Patients
Insights
Carotid pathology is common in Thai stroke patients, often indicated by increased intima-media thickness and plaque, necessitating carotid doppler ultrasonography for evaluation.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Stroke is a significant public health concern in Thailand.
- Carotid artery pathology is a known risk factor for stroke.
- Carotid Doppler Ultrasonography (CDU) is crucial for assessing carotid artery atherosclerosis.
Purpose of the Study:
- To evaluate carotid artery imaging findings using CDU in patients who have experienced a stroke.
- To identify the prevalence and characteristics of carotid pathology in stroke patients.
Main Methods:
- Retrospective study of 170 stroke patients.
- Carotid Doppler Ultrasonography (CDU) performed between January 2011 and May 2016.
- Analysis of carotid intima-media thickness (IMT), plaque morphology, and degree of stenosis.
Main Results:
- 170 stroke patients (mean age 63.9 years; 61.2% male) were studied.
- Elevated carotid intima-media thickness (IMT) and varying degrees of plaque were observed.
- Significant carotid stenosis, near occlusion, and total occlusion were identified in a notable proportion of patients.
Conclusions:
- The majority of stroke patients in this cohort exhibited carotid artery pathology.
- Findings highlight the importance of CDU in detecting carotid atherosclerosis contributing to stroke.
- Progressive disease was observed in follow-up studies, emphasizing the dynamic nature of carotid pathology.
Background:
Strokes constitute a major public healthcare problem in Thailand. Stroke prevalence in Thailand is high, but lower than in highly developed countries, probably due to the high fatality rate here. Carotid pathology is known to be associated with strokes, and carotid doppler ultrasonography (CDU) is a powerful tool for use in evaluating atherosclerosis of the carotid artery.
Objective:
To evaluate carotid imaging pathology by CDU in stroke patients.
Material And Method:
This was a retrospective study of 170 stroke patients who underwent CDU in Rajavithi Hospital between January 2011 and May 2016.
Results:
In all, there were 170 stroke patients with mean age of 63.92±13.97 years (21 to 91 years old); 61.2% were men, and 38.8% were women. Mean carotid IMT of the right and left common carotid artery were 1.08±0.55 mm and 1.11±0.58 mm respectively. Plaque levels at the right and left internal carotid artery were 1.51±0.81 mm and 1.600.86 mm, respectively, and total occlusion of carotid artery was found in 12 patients. Follow-up studies were obtained in 10 cases of whom all had progressive disease: in one patient, the progression of carotid stenosis increased from 70% stenosis to total occlusion, and in another from 53% stenosis to total occlusion. Total occlusion of carotid artery was found in 14 patients.
Conclusion:
Most of these stroke patients had carotid pathology. Many of them had normal carotid velocity, but increasing intima-media thickness and plaque of varying morphology. There were varying degrees of vessel stenosis ranging from no significant stenosis to more than 50% stenosis, 50 to 69% stenosis, more than 70% stenosis, near occlusion and total occlusion.
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