Importance of Intracranial Atherosclerotic Disease in Patients With Symptomatic Stenosis of the Internal Carotid Artery
| Autor: | B. L. Sharpe, L. J. Kappelle, Michael Eliasziw, Allan J. Fox, Henry J.M. Barnett |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty medicine.diagnostic_test business.industry Vascular disease medicine.medical_treatment Carotid endarterectomy medicine.disease Stenosis Relative risk medicine.artery Angiography medicine Neurology (clinical) Radiology Risk factor Internal carotid artery Cardiology and Cardiovascular Medicine business Stroke |
| Zdroj: | Stroke. 30:282-286 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.30.2.282 |
| Popis: | Background and Purpose —The estimated prevalence of intracranial atherosclerotic disease (IAD) in patients with stenosis of the extracranial internal carotid artery (ICA) varies between 20% and 50%. The benefits of carotid endarterectomy (CE) in patients with both IAD and symptomatic extracranial ICA stenosis are uncertain. Methods —The association between IAD and other vascular risk factors and with the risk of stroke at 3 years were studied in patients with symptomatic extracranial ICA stenosis who participated in the North American Symptomatic Carotid Endarterectomy Trial (NASCET). Since the NASCET protocol excluded severe IAD, only a modest number of patients in this category could be studied. Results —IAD was observed in one third of the patients. In medically treated patients, the relative risk of stroke associated with IAD varied from 1.3 (95% CI, 0.9 to 1.9) with extracranial ICA stenosis of Conclusions —IAD is an independent risk factor for subsequent stroke in medically treated patients with symptomatic ICA stenosis. CE reduces this risk. The additional risk imposed by IAD in medically treated patients enhances the value of CE in patients with moderate symptomatic extracranial ICA stenosis. Detection of IAD, requiring angiography, is an important prelude to planning CE in symptomatic patients with moderate extracranial ICA stenosis. |
| Databáze: | OpenAIRE |
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