A Study on First Ischemic Stroke Patients for Prevalence of Extracranial Carotid Artery Stenosis and Risk Factors: Our Experience in Northeast India and Review of Literature

Abstract

Objective: To assess the prevalence of carotid artery stenosis and risk factors in stroke patients of northeast India. This is a prospective hospital-based study on 157 first ischaemic stroke patients of the region. Method: A total of 157 patients presenting with first ever sudden onset focal neurological deficit lasting for more than 24 hours due to acute ischaemic brain infarction were selected, after excluding other causes of focal neurological deficit by imaging. All extracranial carotid arteries were evaluated with carotid ultrasonography. Forty-four patients also had computed tomography (CT) angiography of intracranial and extracranial arteries. Risk factors of stroke were recorded for each patient. Results: Only 8.92% patients had significant extracranial carotid artery stenosis. There was high prevalence of intracranial artery stenosis compared to extracranial artery stenosis in patients who had CT angiography. There was high prevalence of hypertension, dyslipidemia, and diabetes. Increased age and male sex were important factors associated with first ischaemic stroke. Conclusion: The prevalence of significant extracranial carotid artery stenosis is low in northeast Indian patients with first ischaemic stroke, indicating that it is not a major cause of ischaemic stroke in this population. There may be high prevalence of intracranial artery stenosis compared to extracranial artery stenosis.

Study the carotid Doppler and computed tomography of head in ischemic stroke patients

“…Few previous studies also found a high prevalence of carotid stenosis >50% in ischemic stroke patients. 9,11 On further stratification, in the above 50% carotid study, a majority of 47 (37.6%), 40 (32%) cases with 50-69% stenosis were found, 30 (24%) cases with 70-99% stenosis, and a few 8 (6.4%) cases were found to be normal. In a study conducted by Garg et al, out of 354 cases, the prevalence of mild stenosis (<50%) was quite large, with 291 (82.20%) cases.…”

“…From the previous study, the prevalence was 8.92% of carotid stenosis in the Doppler study. 9 With the help of this p value, the sample size was calculated with the formula 2 P(1-P) 2 using the standard sample size calculation (n) = (Z 1-α/2x)/d, where n=sample size and p=estimated prevalence for this study (8.92%), z= 1.96 at a 95% confidence interval, α= type 1 error (0.05), d = margin of error (5%), so our sample size is 125.…”

“…They found the prevalence of significant (50%) extracranial carotid stenosis to be 8.92% with color Doppler carotid sonography. 9 A simple, non-invasive screening procedure like Doppler sonography of the carotid arteries could therefore have profound diagnostic and therapeutic implications in predicting and preventing the potentially fatal and devastating consequences of stroke. Hence, this study is carried out to evaluate the color Doppler findings of carotid artery stenosis in patients presenting with ischemic stroke with CT head in a tertiary care center at Lumbini Medical College and Teaching Hospital.…”

Risk Factors and Distribution Characteristics of Intracranial and Intracranial Artery Stenosis in Young Sufferers with Ischemic Stroke

“…Analysis of the risk factors and distribution characteristics of AS symptoms in young ischemic stroke sufferers is of great significance to improve the prognosis of IS sufferers and reduce the mortality of sufferers [9,10]. However, the distribution characteristics and pathogenic factors of cerebral artery stenosis in young IS sufferers are not clear [11,12]. erefore, this paper takes young sufferers with IS as the research subject and analyzes the risk factors and distribution characteristics of intracranial and intracranial artery stenosis in young sufferers with ischemic stroke.…”

“…Analysis of the risk factors and distribution characteristics of AS symptoms in young ischemic stroke sufferers is of great significance to improve the prognosis of IS sufferers and reduce the mortality of sufferers [ 9 , 10 ]. However, the distribution characteristics and pathogenic factors of cerebral artery stenosis in young IS sufferers are not clear [ 11 , 12 ].…”