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Carotid Doppler Ultrasound in Stroke Patients

Prapasri Eiamthong MD*

Affiliation : * Department of Radiology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

Background : Strokes constitute a major public healthcare problem in Thailand. Stroke prevalence in Thailand is high, but lower than in highly developed countries, probably due to the high fatality rate here. Carotid pathology is known to be associated with strokes, and carotid doppler ultrasonography (CDU) is a powerful tool for use in evaluating atherosclerosis of the carotid artery.
Objective : To evaluate carotid imaging pathology by CDU in stroke patients. Material and Method: This was a retrospective study of 170 stroke patients who underwent CDU in Rajavithi Hospital between January 2011 and May 2016.
Results : In all, there were 170 stroke patients with mean age of 63.92+13.97 years (21 to 91 years old); 61.2% were men, and 38.8% were women. Mean carotid IMT of the right and left common carotid artery were 1.08+0.55 mm and 1.11+0.58 mm respectively. Plaque levels at the right and left internal carotid artery were 1.51+0.81 mm and 1.60+0.86 mm, respectively, and total occlusion of carotid artery was found in 12 patients. Follow-up studies were obtained in 10 cases of whom all had progressive disease: in one patient, the progression of carotid stenosis increased from 70% stenosis to total occlusion, and in another from 53% stenosis to total occlusion. Total occlusion of carotid artery was found in 14 patients.
Conclusion : Most of these stroke patients had carotid pathology. Many of them had normal carotid velocity, but increasing intima-media thickness and plaque of varying morphology. There were varying degrees of vessel stenosis ranging from no significant stenosis to more than 50% stenosis, 50 to 69% stenosis, more than 70% stenosis, near occlusion and total occlusion.

Keywords : Carotid pathology, Carotid IMT, Ischemic stroke, TIA, Permanent stroke, Carotid doppler ultrasonography


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MEDICAL ASSOCIATION OF THAILAND
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