Evaluation of Extracranial Carotid Arteries in Ischemic Stroke Patients Using Color Doppler Sonography and Correlation with Various Risk Factors

Abstract

Background: Cerebral ischemic stroke is the major cause of death after ischemic heart disease and malignancies, among which major cases of stroke results from atherosclerosis of intra and extra-cranial carotid vessels. The aim of this study is to evaluate the extracranial carotid arteries in patients with ischemic stroke and correlation with various risk factors.
 Materials and Methods: A cross sectional study of the patients with ischemic stroke presented in Radiology department of Nobel Medical College were evaluated for a period of one year from February 2017- January 2018 using color Doppler ultrasound and correlated with various risk factors. A total of 50 patients were included in the study. All age groups and sex were included.
 Results: Out of 50 patients, 29 patients (58%) were males and 21 patients (42%) were females. Stroke was present in 24 patients on right side and 26 patients on left side. A total of 36 patients had extra-cranial carotid stenosis. Among them, 18 patients had <50% stenosis, 17 patients had >50% stenosis and 1 patient had complete occlusion. The most common cause of obstruction was found to be atherosclerotic changes in the form of atheromatous plaque. Out of 50 patients 27 had history of hypertension and 19 had history of smoking. Out of 27 hypertensive patients, 23 had stenosis which is statistically significant (p value 0.024). 
 Conclusion: The current study shows the importance of color Doppler ultrasound as an economic, safe and non-invasive method of demonstrating the cause of stroke in extra-cranial carotid artery system

Visualization of Carotid Doppler in Patients with Ischemic Stroke at Dr. Hasan Sadikin General Hospital Bandung Year 2016-2019

“…This finding differs from previous evidence in which the extracranial carotid artery was the most common plaque location. 4,11 This is probably due to ethnic differences, where atherosclerotic lesions in Asian people are more frequently found in the intracranial vessels. 12 The causes are still unknown but presumably related to genetics and nutritional factors.…”

“…This study has similar findings to a study in India which showed that more plaque is located in the common carotid artery. 11 Vulnerable plaque, indicated as plaque with a high degree of echolucency, is prone to rupture and may result in thrombus formation. In this study, the most common plaque found was type III, followed by type II, indicating that the plaque found was more stable.…”