E Johansson1, K Öhman, P Wester. 1. Department of Pharmacology and Clinical Neuroscience and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Abstract
BACKGROUND: The risk of early stroke recurrence amongst patients with symptomatic carotid near-occlusion with and without full collapse is unknown. Therefore, the aim of this study was to analyse the 90-day risk of recurrent ipsilateral ischaemic stroke in patients with symptomatic carotid near-occlusion both with and without full collapse. METHODS: This study was a secondary analysis of the Additional Neurological SYmptoms before Surgery of the Carotid Arteries: a Prospective study (ANSYSCAP). We prospectively analysed 230 consecutive patients with symptomatic 50-99% carotid stenosis or near-occlusion. Based on the combination of several imaging modalities, 205 (89%) patients were classified as having 50-99% carotid stenosis, and 10 (4%) and 15 (7%) as having near-occlusion with and without full collapse, respectively. The 90-day risk of recurrent ipsilateral ischaemic stroke was compared between these three groups. Only events that occurred before carotid endarterectomy were analysed. RESULTS: The 90-day risk of recurrent stroke was 18% [95% confidence interval (CI) 12-25%; n = 29] for patients with 50-99% carotid stenosis, 0% for patients with near-occlusion without full collapse and 43% (95% CI 25-89%; n = 4) for patients with near-occlusion with full collapse (P = 0.035, log-rank test). The increased risk of recurrent ipsilateral ischaemic stroke for patients with symptomatic near-occlusion with full collapse remained significant after multivariable adjustment for age, sex and type of presenting event. CONCLUSIONS: Patients with symptomatic carotid near-occlusion with full collapse might have a very high risk of stroke recurrence. Carotid endarterectomy could be considered for these patients.
BACKGROUND: The risk of early stroke recurrence amongst patients with symptomatic carotid near-occlusion with and without full collapse is unknown. Therefore, the aim of this study was to analyse the 90-day risk of recurrent ipsilateral ischaemic stroke in patients with symptomatic carotid near-occlusion both with and without full collapse. METHODS: This study was a secondary analysis of the Additional Neurological SYmptoms before Surgery of the Carotid Arteries: a Prospective study (ANSYSCAP). We prospectively analysed 230 consecutive patients with symptomatic 50-99% carotid stenosis or near-occlusion. Based on the combination of several imaging modalities, 205 (89%) patients were classified as having 50-99% carotid stenosis, and 10 (4%) and 15 (7%) as having near-occlusion with and without full collapse, respectively. The 90-day risk of recurrent ipsilateral ischaemic stroke was compared between these three groups. Only events that occurred before carotid endarterectomy were analysed. RESULTS: The 90-day risk of recurrent stroke was 18% [95% confidence interval (CI) 12-25%; n = 29] for patients with 50-99% carotid stenosis, 0% for patients with near-occlusion without full collapse and 43% (95% CI 25-89%; n = 4) for patients with near-occlusion with full collapse (P = 0.035, log-rank test). The increased risk of recurrent ipsilateral ischaemic stroke for patients with symptomatic near-occlusion with full collapse remained significant after multivariable adjustment for age, sex and type of presenting event. CONCLUSIONS:Patients with symptomatic carotid near-occlusion with full collapse might have a very high risk of stroke recurrence. Carotid endarterectomy could be considered for these patients.
Authors: Simon R Khangure; Hadas Benhabib; Matylda Machnowska; Allan J Fox; Christer Grönlund; Wendy Herod; Robert Maggisano; Anders Sjöberg; Per Wester; Seyed-Parsa Hojjat; Julia Hopyan; Richard I Aviv; Elias Johansson Journal: Neuroradiology Date: 2017-11-25 Impact factor: 2.804
Authors: Suvi Maaria Koskinen; Heli Silvennoinen; Petra Ijäs; Krista Nuotio; Leena Valanne; Perttu J Lindsberg; Lauri Soinne Journal: Neuroradiology Date: 2017-03-01 Impact factor: 2.804
Authors: A Garcia-Pastor; A Gil-Núñez; J M Ramirez-Moreno; N González-Nafría; J Tejada; F Moniche; J C Portilla-Cuenca; P Martínez-Sánchez; B Fuentes; M A Gamero-García; M A de Leciñana; J Masjuan; D C Verge; Y Aladro; V Parkhutik; A Lago; A M de Arce-Borda; M Usero-Ruiz; R Delgado-Mederos; A Pampliega; Á Ximenez-Carrillo; M Bártulos-Iglesias; E Castro-Reyes Journal: AJNR Am J Neuroradiol Date: 2022-08-18 Impact factor: 4.966