Euro MedNews

Carotid artery disease and the severity of cerebrovascular accidents

Sajecar (Serbia), 7 June 2004 – Cerebrovascular disease is the third highest cause of mortality after cardiovascular diseases and malignant neoplasms, and it is well understood that a high percentage of cerebrovascular accidents (CVA) originate in the carotid artery. Researchers at the Institute for Prevention, Treatment and Rehabilitation of Rheumatic and Cardiovascular Diseases in Niška Banja in Serbia have carried out a study to estimate the presence, severity, and importance of neurological accidents in coronary patients due to carotid artery disease. The study included 52 patients: 23% had suffered a transitory ischaemic attack (TIA), 65% had had a minor stoke, and 12% a major stroke. The researchers found a significantly positive correlation between stenosis diameter and severity of neurological accidents: in the TIA, minor stroke, and major stoke groups, stenosis was 34%, 52%, and 78%, respectively.

The researchers warn against underestimating lesions under 50% – although such plaques are often haemodynamically not significant in aspect, they can be soft, lipid-rich, fragile, have a thin cover, and can rupture, resulting in CVA. The results of the study indicate that patients with coronary as well as neurological risk factors should undergo clinical and ultrasound examination of carotid arteries towards formulating an optimal and rational treatment strategy, whether conservative or surgical. Color Doppler echosonography, the non-invasive diagnostic method of first choice, should be performed regularly on all neurological patients. Statins, anticoagulants, and angiotensin-converting enzyme (ACE) inhibitors are considered the ‘golden trio’ in modern cardiovascular disease therapy. Surgical endartherectomy is reserved for symptomatic patients with stenosis over 70% or asymptomatic patients with stenosis over 80% and multiple risk factors. Stenting is reserved for elderly patients or patients with increased surgery risk.

Source: Timocki medicinski glasnik (Serbia and Montenegro)
Reference: Tim med glas 29(2004),1,5 – 7
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