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Symptomatic carotid near-occlusion with full collapse might cause a very high risk of stroke
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Radiation Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.ORCID iD: 0000-0003-0394-5096
2015 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 277, no 5, 615-623 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundThe risk of early stroke recurrence amongst patients with symptomatic carotid near-occlusion with and without full collapse is unknown. Therefore, the aim of this study was to analyse the 90-day risk of recurrent ipsilateral ischaemic stroke in patients with symptomatic carotid near-occlusion both with and without full collapse. MethodsThis study was a secondary analysis of the Additional Neurological SYmptoms before Surgery of the Carotid Arteries: a Prospective study (ANSYSCAP). We prospectively analysed 230 consecutive patients with symptomatic 50-99% carotid stenosis or near-occlusion. Based on the combination of several imaging modalities, 205 (89%) patients were classified as having 50-99% carotid stenosis, and 10 (4%) and 15 (7%) as having near-occlusion with and without full collapse, respectively. The 90-day risk of recurrent ipsilateral ischaemic stroke was compared between these three groups. Only events that occurred before carotid endarterectomy were analysed. ResultsThe 90-day risk of recurrent stroke was 18% [95% confidence interval (CI) 12-25%; n=29] for patients with 50-99% carotid stenosis, 0% for patients with near-occlusion without full collapse and 43% (95% CI 25-89%; n=4) for patients with near-occlusion with full collapse (P=0.035, log-rank test). The increased risk of recurrent ipsilateral ischaemic stroke for patients with symptomatic near-occlusion with full collapse remained significant after multivariable adjustment for age, sex and type of presenting event. ConclusionsPatients with symptomatic carotid near-occlusion with full collapse might have a very high risk of stroke recurrence. Carotid endarterectomy could be considered for these patients.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015. Vol. 277, no 5, 615-623 p.
Keyword [en]
carotid near-occlusion, carotid stenosis, CEA, risk, stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-103136DOI: 10.1111/joim.12318ISI: 000352801300012PubMedID: 25297638OAI: oai:DiVA.org:umu-103136DiVA: diva2:815144
Available from: 2015-05-29 Created: 2015-05-18 Last updated: 2017-05-11Bibliographically approved

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Johansson, EliasWester, Per

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