The Effects of Carotid Pathologies on Short-Term Functional Outcomes After First-Ever Small Vessel Occlusion Stroke

Area of Science:

• Cerebrovascular disease research
• Stroke outcome prediction
• Carotid artery imaging

Background:

• Carotid pathologies are known stroke risk factors, but their impact on non-atherosclerotic stroke outcomes is unclear.
• Small vessel occlusion (SVO) stroke outcomes require further investigation regarding associated pathologies.
• Understanding predictors of functional dependence after SVO is crucial for patient management.

Purpose of the Study:

• To investigate the association between carotid pathologies and functional dependence 3 months post-SVO stroke.
• To identify independent predictors of functional dependence in SVO stroke patients.
• To clarify the role of carotid plaque characteristics in SVO stroke prognosis.

Main Methods:

• Retrospective analysis of 372 first-ever SVO stroke patients.
• Carotid plaque grading using standardized ultrasound criteria.
• Functional outcome assessment at 3 months using the modified Rankin scale (mRS).
• Logistic regression analysis to determine predictors of functional dependence (mRS ≥2).

Main Results:

• Carotid plaque grade III showed a univariable association with functional dependence (OR 2.46, p=0.049), but this was not significant in multivariable analysis.
• Age (aOR 1.07), initial NIH Stroke Scale (NIHSS) score (aOR 1.84), and diabetes (aOR 2.84) were independently associated with functional dependence.
• 96 out of 372 patients experienced functional dependence at 3 months.

Conclusions:

• Carotid plaque severity is not an independent predictor of functional outcomes 3 months after SVO stroke.
• Age, initial NIHSS, and diabetes are significant independent predictors of functional dependence post-SVO.
• Further research is needed to understand the complex interplay of factors influencing SVO stroke outcomes, especially in patients with concurrent carotid pathologies.