Carotid Ultrasound for Assessment of Nonobstructive Carotid Atherosclerosis in Young Adults with Cryptogenic Stroke.
J Stroke Cerebrovasc Dis
; 27(5): 1212-1216, 2018 May.
Article
em En
| MEDLINE
| ID: mdl-29307510
ABSTRACT
BACKGROUND:
The role of nonobstructive (<50% stenosis) carotid atherosclerosis (NOCA) in young adults with ischemic stroke is not well understood. In the present study, we investigated the prevalence and the ultrasonic characteristics of NOCA in a consecutive series of young adults with cryptogenic stroke (CS).METHODS:
Patients aged 18-54, consecutively treated in a tertiary hospital for first-ever CS (defined as an ischemic stroke without ASCOD (A atherosclerosis; S small-vessel disease; C cardiac pathology; O other causes) grade 1 potential cause) in the carotid artery territory, were prospectively enrolled. NOCA was assessed using carotid duplex ultrasonography.RESULTS:
Of 148 patients with first-ever ischemic stroke, 70 had CS, including 44 patients with carotid CS. NOCA was found in 22 of 44 (50%) patients. All but 1 plaque were echolucent. NOCA was bilateral in 15 patients and unilateral in 7 patients. All unilateral plaques were on the symptomatic side (P = .02). Plaque thickness, plaque length, and plaque volume were greater on the symptomatic side than on the asymptomatic side (P = .001, P < .001, and P < .001, respectively). Discrimination between the symptomatic and the asymptomatic side using any of these plaque metrics was good with areas under the curve (95% confidence interval) of .82 (.69-0.95), .85 (.74-0.96), and .87 (.75-0.99) for plaque thickness, plaque length, and plaque volume, respectively.CONCLUSIONS:
NOCA is frequent in young adults with CS. Measurement of the plaque burden with carotid duplex may help to identify symptomatic NOCA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artérias Carótidas
/
Estenose das Carótidas
/
Ultrassonografia Doppler em Cores
/
Acidente Vascular Cerebral
/
Placa Aterosclerótica
Tipo de estudo:
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Assunto da revista:
ANGIOLOGIA
/
CEREBRO
Ano de publicação:
2018
Tipo de documento:
Article