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Defining carotid near-occlusion with full collapse: a pooled analysis
Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM). Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0001-5317-4563
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0002-0560-3578
Sunnybrook Health Science Centre, 2075 Bayview Ave, ON, Toronto, Canada.
2022 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 64, p. 59-67Article in journal (Refereed) Published
Abstract [en]

Purpose: Create a new definition of near-occlusion with full collapse to predicting recurrent stroke.

Methods: Pooled analysis of two studies. Patients with symptomatic ≥ 50% carotid stenoses were included. Outcome was preoperative recurrent ipsilateral ischemic stroke or retinal artery occlusion within 28 days of presenting event. We analyzed several artery diameters on computed tomography angiography and stenosis velocity on ultrasound.

Results: A total of 430 patients with symptomatic ≥ 50% carotid stenosis were included, 27% had near-occlusion. By traditional definition, 27% with full collapse and 11% without full collapse reached the outcome (p = 0.047). Distal internal carotid artery (ICA) diameter, ICA ratio, and ICA-to-external carotid artery ratio were associated with the outcome. Best new definition of full collapse was distal ICA diameter ≤ 2.0 mm and/or ICA ratio ≤ 0.42. With this new definition, 36% with full collapse and 4% without full collapse reached the outcome (p < 0.001).

Conclusions: Defining near-occlusion with full collapse as distal ICA diameter ≤ 2.0 mm and/or ICA ratio ≤ 0.42 seems to yield better prognostic discrimination than the traditional appearance-based definition. This novel definition can be used in prognostic and treatment studies of near-occlusion with full collapse.

Place, publisher, year, edition, pages
Springer-Verlag New York, 2022. Vol. 64, p. 59-67
Keywords [en]
Carotid near-occlusion, Carotid stenosis, CT-angiography, Stroke, Ultrasound
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-183576DOI: 10.1007/s00234-021-02728-5ISI: 000647087400001Scopus ID: 2-s2.0-85105247580OAI: oai:DiVA.org:umu-183576DiVA, id: diva2:1559574
Available from: 2021-06-02 Created: 2021-06-02 Last updated: 2023-03-24Bibliographically approved

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Johansson, EliasGu, Thomas

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