Περίληψη:
Background and Purpose-The ability to predict future strokes in
asymptomatic patients with carotid stenosis is currently limited. The
management of symptomatic patients with < 50% stenosis is also
debatable, In this context, we performed the following open prospective
study to identify factors affecting symptomatology in patients with
carotid stenosis.
Methods-During 1988-1997, 442 arteries with various degrees of stenosis
were followed with the use of color Duplex ultrasonography every 6
months. The main outcome measures were development of symptoms related
to the carotid territory and progression in the degree of stenosis.
Results Of follow-up were analyzed in relation to the traditional risk
factors for atherosclerosis as well as the ultrasonographic
characteristics of the plaques. Statistical analysis was performed by
multiple linear and Cox regression analysis. Results-Mean duration of
follow-up was 44 months (range, 12 to 120 months). Significant
progression of stenosis occurred in 18.5% of the cases and was more
frequent in younger patients (P = 0.09), in patients with coronary
artery disease (P = 0.02), and in patients with echolucent plaques (P =
0.02), In regard to clinical presentation, men (P = 0.07), hypertensives
(P = 0.07), and patients with echolucent plaques (P = 0.09) showed a
trend toward higher frequency of stroke in their history. During the
follow-up period. neurological events developed in 12.4% of the cases
and were associated with the severity of carotid disease (P < 0.001),
history of neurological events (P = 0.02), progression of stenosis (P =
0.002). echolucent plaques (P = 0.01). and hypertension (P = 0.02).
Conclusions-Factors other than de-ree of stenosis and history of
neurological events are also important in determining high-risk carotid
plaque. In our study hypertension. echolucent plaques, and progressive
lesions were associated with an increased risk of neurological events.
These factors should be taken into consideration in determining
treatment strategies for carotid stenosis.
Συγγραφείς:
Liapis, CD
Kakisis, JD
Kostakis, AG
