Introduction. Stroke is the fourth leading cause of death in the United States and the leading cause of disability. Of these, carotid artery disease is responsible for up to 15% to 30% of strokes. The objetive is knowing the risk factors and their impact on four possible scenarios in the diagnosis and treatment of carotid artery disease. 1: significant stenosis measured by ultrasound Doppler carotid, 2: significant stenosis measured by diagnostic cerebral angiography, 3: plaque ulceration measured by angiography, and 4: carotid stent placement. Material and Methods. A retrospective study was carried out with 29 patients, 12 patients to whom was placed a carotid stent and 17 control patients, Odds ratio was calculated for risk factors: high blood pressure, diabetes, cancer, smoking and dyslipidemia. And then multivariate analysis was performed with the same variables. Results. For the risk factors with statistical significance for carotid ulcer were dyslipidemia and cancer, and for stent placement, smoking, and clinically presented as a transient ischemic attack. For the multivariate analysis, the only factor associated with stent placement was smoking. Conclusions. Of the entire range of risk factors associated with cerebrovascular disease, tobacco use is the factor most strongly associated with a patient with carotid disease ending up in endovascular treatment. So prevention or lifestyle modification is the best tool to avoid these outcomes.
| Published in | International Journal of Neurosurgery (Volume 6, Issue 1) |
| DOI | 10.11648/j.ijn.20220601.13 |
| Page(s) | 11-18 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Carotid Artery Disease, Ulcerated Carotid Plaque, Carotid Stent, Transient Isquemic Attack, Stroke
| [1] | Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, et al. Heart Disease and Stroke Statistics—2014 Update: A Report From the American Heart Association. Circulation [Internet]. 2014 [cited 2020 Dec 26]; 129. Available from: https://www.ahajournals.org/doi/10.1161/01.cir.0000441139.02102.80 |
| [2] | Cantu-Brito C, Majersik JJ, Sánchez BN, Ruano A, Becerra-Mendoza D, Wing JJ, Morgenstern LB. Door-to-Door Capture of Incident and Prevalent Stroke Cases in Durango, Mexico: The Brain Attack Surveillance in Durango Study. Stroke. 2011; 42: 601–606. |
| [3] | SECRETARY OF HEALTH, UNDERSECRETARY OF HEALTH PROMOTION AND PREVENTION, DIRECTORATE GENERAL OF EPIDEMIOLOGY. Epidemiological and Statistical Overview of Mortality Due to Causes Subject to Epidemiological Surveillance in Mexico 2017. Available from: www.salud.gob.mx |
| [4] | Petty GW, Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO. Ischemic Stroke Subtypes: A Population-Based Study of Incidence and Risk Factors. Stroke. 1999; 30: 2513–2516. |
| [5] | Cilingiroglu M, Marmagkiolis K, Wholey MH. Carotid artery stenting update. Future Cardiology. 2013; 9: 193–197. |
| [6] | Naqvi TZ, Lee M-S. Carotid Intima-Media Thickness and Plaque in Cardiovascular Risk Assessment. JACC: Cardiovascular Imaging. 2014; 7: 1025–1038. |
| [7] | LeFevre ML, on behalf of the U.S. Preventive Services Task Force. Screening for Asymptomatic Carotid Artery Stenosis: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2014; 161: 356. |
| [8] | Woo SY, Joh JH, Han S-A, Park H-C. Prevalence and risk factors for atherosclerotic carotid stenosis and plaque: A population-based screening study. Medicine. 2017; 96: e5999. |
| [9] | de Weerd M, Greving JP, Hedblad B, Lorenz MW, Mathiesen EB, O’Leary DH, Rosvall M, Sitzer M, de Borst GJ, Buskens E, et al. Prediction of Asymptomatic Carotid Artery Stenosis in the General Population: Identification of High-Risk Groups. Stroke. 2014; 45: 2366–2371. |
| [10] | Ballotta E, Angelini A, Mazzalai F, Piatto G, Toniato A, Baracchini C. Carotid endarterectomy for symptomatic low-grade carotid stenosis. Journal of Vascular Surgery. 2014; 59: 25–31. |
| [11] | Brinjikji W, Huston J, Rabinstein AA, Kim G-M, Lerman A, Lanzino G. Contemporary carotid imaging: from degree of stenosis to plaque vulnerability. JNS. 2016; 124: 27–42. |
| [12] | Homburg PJ, Rozie S, van Gils MJ, van den Bouwhuijsen QJA, Niessen WJ, Dippel DWJ, van der Lugt A. Association Between Carotid Artery Plaque Ulceration and Plaque Composition Evaluated With Multidetector CT Angiography. Stroke. 2011; 42: 367–372. |
| [13] | Porcu M, Mannelli L, Melis M, Suri JS, Gerosa C, Cerrone G, Defazio G, Faa G, Saba L. Carotid plaque imaging profiling in subjects with risk factors (diabetes and hypertension). Cardiovasc Diagn Ther. 2020; 10: 1005–1018. |
| [14] | Barry R, Pienaar C, Nel CJC. Accuracy of B-Mode Ultrasonography in Detecting Carotid Plaque Hemorrhage and Ulceration. Annals of Vascular Surgery. 1990; 4: 466–470. |
| [15] | Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, Wollum A, Sanman E, Wulf S, Lopez AD, et al. Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012. JAMA. 2014; 311: 183. |
| [16] | Villatorio-Velázquez JA., Resendez-Escobar, E., Mujica-Salazar, A., Bretón-Cirett, M., Cañas-Martínez, V., Soto-Hernández, I., Fregoso-Ito, D., Fleiz-Bautista, C., Medina-Mora ME., Gutiérrez-Reyes, J., Franco-Núñez, A., Romero-Martínez, M. y Mendoza-Alvarado, L. Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017: Reporte de Drogas. 2017. |
| [17] | Kwan J, Horsfield G, Bryant T, Gawne-Cain M, Durward G, Byrne CD, Englyst NA. IL-6 is a predictive biomarker for stroke associated infection and future mortality in the elderly after an ischemic stroke. Experimental Gerontology. 2013; 48: 960–965. |
| [18] | Tuttolomondo A, Di Sciacca R, Di Raimondo D, Pedone C, La Placa S, Pinto A, Licata G. Effects of clinical and laboratory variables and of pretreatment with cardiovascular drugs in acute ischaemic stroke: A retrospective chart review from the GIFA study. International Journal of Cardiology. 2011; 151: 318–322. |
| [19] | Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke: A meta-analysis. Medicine. 2019; 98: e14872. |
| [20] | Mack WJ, Islam T, Lee Z, Selzer RH, Hodis HN. Environmental tobacco smoke and carotid arterial stiffness. Preventive Medicine. 2003; 37: 148–154. |
| [21] | Rehill N, Beck CR, Yeo KR, Yeo WW. The effect of chronic tobacco smoking on arterial stiffness. Br J Clin Pharmacol. 2006; 61: 767–773. |
| [22] | Kiriyama H, Kaneko H, Itoh H, Yoshida Y, Nakanishi K, Mizuno Y, Daimon M, Morita H, Yamamichi N, Komuro I. Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study. Heart Vessels. 2020; 35: 22–29. |
| [23] | Redgrave JNE, Lovett JK, Rothwell PM. Histological Features of Symptomatic Carotid Plaques in Relation to Age and Smoking: The Oxford Plaque Study. Stroke. 2010; 41: 2288–2294. |
| [24] | Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease. Journal of the American College of Cardiology. 2004; 43: 1731–1737. |
| [25] | Wajngarten M, Silva GS. Hypertension and Stroke: Update on Treatment. Eur Cardiol. 2019; 14: 111–115. |
| [26] | Flint AC, Conell C, Ren X, Banki NM, Chan SL, Rao VA, Melles RB, Bhatt DL. Effect of Systolic and Diastolic Blood Pressure on Cardiovascular Outcomes. N Engl J Med. 2019; 381: 243–251. |
| [27] | Lindholm LH, Carlberg B, Samuelsson O. Should β blockers remain first choice in the treatment of primary hypertension? A meta-analysis. The Lancet. 2005; 366: 1545–1553. |
| [28] | Yin J, Yu C, Liu H, Du M, Sun F, Yu C, Wei L, Wang C, Wang X. A model to predict unstable carotid plaques in population with high risk of stroke. BMC Cardiovasc Disord. 2020; 20: 164. |
| [29] | Liu A, Yu Z, Wang N, Wang W. Carotid atherosclerosis is associated with hypertension in a hospital-based retrospective cohort. Int J Clin Exp Med. 2015; 8: 21932–21938. |
| [30] | Cuspidi C, Tadic M, Sala C. Carotid atherosclerosis progression: the importance of systolic blood pressure. Hypertens Res. 2014; 37: 890–891. |
| [31] | Chien JD, Furtado A, Cheng S-C, Lam J, Schaeffer S, Chun K, Wintermark M. Demographics of carotid atherosclerotic plaque features imaged by computed tomography. Journal of Neuroradiology. 2013; 40: 1–10. |
| [32] | Lovett JK, Howard SC, Rothwell PM. Pulse pressure is independently associated with carotid plaque ulceration: Journal of Hypertension. 2003; 21: 1669–1676. |
| [33] | IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes: recommendations for standard, comprehensive, and minimal care. Diabet Med. 2006; 23: 579–593. |
| [34] | Hayden MR, Tyagi SC. Vasa vasorum in plaque angiogenesis, metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: a malignant transformation. Cardiovasc Diabetol. 2004; 3: 1. |
| [35] | Esposito L, Saam T, Heider P, Bockelbrink A, Pelisek J, Sepp D, Feurer R, Winkler C, Liebig T, Holzer K, et al. MRI plaque imaging reveals high-risk carotid plaques especially in diabetic patients irrespective of the degree of stenosis. BMC Med Imaging. 2010; 10: 27. |
| [36] | Hoke M, Schillinger M, Minar E, Goliasch G, Binder CJ, Mayer FJ. Carotid ultrasound investigation as a prognostic tool for patients with diabetes mellitus. Cardiovasc Diabetol. 2019; 18: 90. |
| [37] | Sun B, Zhao H, Liu X, Lu Q, Zhao X, Pu J, Xu J. Elevated hemoglobin A1c Is Associated with Carotid Plaque Vulnerability: Novel Findings from Magnetic Resonance Imaging Study in Hypertensive Stroke Patients. Sci Rep. 2016; 6: 33246. |
| [38] | Purushothaman K-R, Purushothaman M, Muntner P, Lento PA, O’Connor WN, Sharma SK, Fuster V, Moreno PR. Inflammation, neovascularization and intra-plaque hemorrhage are associated with increased reparative collagen content: Implication for plaque progression in diabetic atherosclerosis. Vasc Med. 2011; 16: 103–108. |
| [39] | van den Oord SCH, Akkus Z, Renaud G, Bosch JG, van der Steen AFW, Sijbrands EJG, Schinkel AFL. Assessment of carotid atherosclerosis, intraplaque neovascularization, and plaque ulceration using quantitative contrast-enhanced ultrasound in asymptomatic patients with diabetes mellitus. European Heart Journal - Cardiovascular Imaging. 2014; 15: 1213–1218. |
| [40] | Katsiki N, Mikhailidis DP. Diabetes and carotid artery disease: a narrative review. Ann Transl Med. 2020; 8: 1280–1280. |
| [41] | Mi T, Sun S, Zhang G, Carora Y, Du Y, Guo S, Cao M, Zhu Q, Wang Y, Sun Q, et al. Relationship between dyslipidemia and carotid plaques in a high‐stroke‐risk population in Shandong Province, China. Brain Behav [Internet]. 2016 [cited 2020 Dec 26]; 6. Available from: https://onlinelibrary.wiley.com/doi/10.1002/brb3.473 |
| [42] | Miura Y, Suzuki H. Dyslipidemia and atherosclerotic carotid artery stenosis. VP [Internet]. 2019 [cited 2020 Dec 26]; 2019. Available from: https://vpjournal.net/article/view/2952 |
| [43] | Borén J, Taskinen M-R, Olofsson S-O, Levin M. Ectopic lipid storage and insulin resistance: a harmful relationship. J Intern Med. 2013; 274: 25–40. |
| [44] | Vouillarmet J, Helfre M, Maucort-Boulch D, Riche B, Thivolet C, Grange C. Carotid atherosclerosis progression and cerebrovascular events in patients with diabetes. Journal of Diabetes and its Complications. 2016; 30: 638–643. |
| [45] | Dardiotis E, Aloizou A-M, Markoula S, Siokas V, Tsarouhas K, Tzanakakis G, Libra M, Kyritsis A, Brotis A, Aschner M, et al. Cancer-associated stroke: Pathophysiology, detection and management (Review). Int J Oncol [Internet]. 2019 [cited 2020 Dec 26]; Available from: http://www.spandidos-publications.com/10.3892/ijo.2019.4669 |
| [46] | Grisold W, Oberndorfer S, Struhal W. Stroke and cancer: a review. Acta Neurologica Scandinavica. 2009; 119: 1–16. |
| [47] | Taccone FS, Jeangette SM, Blecic SA. First-Ever Stroke as Initial Presentation of Systemic Cancer. Journal of Stroke and Cerebrovascular Diseases. 2008; 17: 169–174. |
| [48] | Graus F, Rogers LR, Posner JB. Cerebrovascular Complications in Patients with Cancer: Medicine. 1985; 64: 16–35. |
| [49] | Moreira LAR, Silva EN, Ribeiro ML, Martins W de A. Cardiovascular effects of radiotherapy on the patient with cancer. Rev. Assoc. Med. Bras. 2016; 62: 192–196. |
| [50] | Romeiro AC, Valadas A, Marques J. Acute Ischemic Stroke on Cancer Patients, a Distinct Etiology? A Case-Control Study. Acta Med Port. 2015; 28: 613. |
| [51] | Stefan O, Vera N, Otto B, Heinz L, Wolfgang G. Stroke in cancer patients: a risk factor analysis. J Neurooncol. 2009; 94: 221–226. |
| [52] | Morris B, Partap S, Yeom K, Gibbs IC, Fisher PG, King AA. Cerebrovascular disease in childhood cancer survivors: A Children’s Oncology Group Report. Neurology. 2009; 73: 1906–1913. |
| [53] | Krawczuk-Rybak M, Tomczuk-Ostapczuk M, Panasiuk A, Goscik E. Carotid intima-media thickness in young survivors of childhood cancer. J Med Imaging Radiat Oncol. 2017; 61: 85–92. |
| [54] | Eliasziw M, Streifler JY, Fox AJ, Hachinski VC, Ferguson GG, Barnett HJ. Significance of plaque ulceration in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial. Stroke. 1994; 25: 304–308. |
| [55] | Song P, Fang Z, Wang H, Cai Y, Rahimi K, Zhu Y, Fowkes FGR, Fowkes FJI, Rudan I. Global and regional prevalence, burden, and risk factors for carotid atherosclerosis: a systematic review, meta-analysis, and modelling study. The Lancet Global Health. 2020; 8: e721–e729. |
APA Style
Daniel Alejandro Vega-Moreno, José Ramón Aguilar-Calderón, María Elena Córdoba-Mosqueda, Víctor Andrés Reyes-Rodríguez, Mauricio Daniel Sánchez-Calderón, et al. (2022). Carotid Artery Disease: Multivariate Analysis of a Single Center in Mexico City. International Journal of Neurosurgery, 6(1), 11-18. https://doi.org/10.11648/j.ijn.20220601.13
ACS Style
Daniel Alejandro Vega-Moreno; José Ramón Aguilar-Calderón; María Elena Córdoba-Mosqueda; Víctor Andrés Reyes-Rodríguez; Mauricio Daniel Sánchez-Calderón, et al. Carotid Artery Disease: Multivariate Analysis of a Single Center in Mexico City. Int. J. Neurosurg. 2022, 6(1), 11-18. doi: 10.11648/j.ijn.20220601.13
AMA Style
Daniel Alejandro Vega-Moreno, José Ramón Aguilar-Calderón, María Elena Córdoba-Mosqueda, Víctor Andrés Reyes-Rodríguez, Mauricio Daniel Sánchez-Calderón, et al. Carotid Artery Disease: Multivariate Analysis of a Single Center in Mexico City. Int J Neurosurg. 2022;6(1):11-18. doi: 10.11648/j.ijn.20220601.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijn.20220601.13,
author = {Daniel Alejandro Vega-Moreno and José Ramón Aguilar-Calderón and María Elena Córdoba-Mosqueda and Víctor Andrés Reyes-Rodríguez and Mauricio Daniel Sánchez-Calderón and José Omar Santellán-Hernández and Diego Ochoa-Cacique and Carlos Betancourt-Quiroz and Mario Alberto Dueñas-Espinoza and Andrés Alberto Moral-Naranjo and Martha Elena González-Jiménez and Ulises García-González},
title = {Carotid Artery Disease: Multivariate Analysis of a Single Center in Mexico City},
journal = {International Journal of Neurosurgery},
volume = {6},
number = {1},
pages = {11-18},
doi = {10.11648/j.ijn.20220601.13},
url = {https://doi.org/10.11648/j.ijn.20220601.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220601.13},
abstract = {Introduction. Stroke is the fourth leading cause of death in the United States and the leading cause of disability. Of these, carotid artery disease is responsible for up to 15% to 30% of strokes. The objetive is knowing the risk factors and their impact on four possible scenarios in the diagnosis and treatment of carotid artery disease. 1: significant stenosis measured by ultrasound Doppler carotid, 2: significant stenosis measured by diagnostic cerebral angiography, 3: plaque ulceration measured by angiography, and 4: carotid stent placement. Material and Methods. A retrospective study was carried out with 29 patients, 12 patients to whom was placed a carotid stent and 17 control patients, Odds ratio was calculated for risk factors: high blood pressure, diabetes, cancer, smoking and dyslipidemia. And then multivariate analysis was performed with the same variables. Results. For the risk factors with statistical significance for carotid ulcer were dyslipidemia and cancer, and for stent placement, smoking, and clinically presented as a transient ischemic attack. For the multivariate analysis, the only factor associated with stent placement was smoking. Conclusions. Of the entire range of risk factors associated with cerebrovascular disease, tobacco use is the factor most strongly associated with a patient with carotid disease ending up in endovascular treatment. So prevention or lifestyle modification is the best tool to avoid these outcomes.},
year = {2022}
}
TY - JOUR T1 - Carotid Artery Disease: Multivariate Analysis of a Single Center in Mexico City AU - Daniel Alejandro Vega-Moreno AU - José Ramón Aguilar-Calderón AU - María Elena Córdoba-Mosqueda AU - Víctor Andrés Reyes-Rodríguez AU - Mauricio Daniel Sánchez-Calderón AU - José Omar Santellán-Hernández AU - Diego Ochoa-Cacique AU - Carlos Betancourt-Quiroz AU - Mario Alberto Dueñas-Espinoza AU - Andrés Alberto Moral-Naranjo AU - Martha Elena González-Jiménez AU - Ulises García-González Y1 - 2022/05/10 PY - 2022 N1 - https://doi.org/10.11648/j.ijn.20220601.13 DO - 10.11648/j.ijn.20220601.13 T2 - International Journal of Neurosurgery JF - International Journal of Neurosurgery JO - International Journal of Neurosurgery SP - 11 EP - 18 PB - Science Publishing Group SN - 2640-1959 UR - https://doi.org/10.11648/j.ijn.20220601.13 AB - Introduction. Stroke is the fourth leading cause of death in the United States and the leading cause of disability. Of these, carotid artery disease is responsible for up to 15% to 30% of strokes. The objetive is knowing the risk factors and their impact on four possible scenarios in the diagnosis and treatment of carotid artery disease. 1: significant stenosis measured by ultrasound Doppler carotid, 2: significant stenosis measured by diagnostic cerebral angiography, 3: plaque ulceration measured by angiography, and 4: carotid stent placement. Material and Methods. A retrospective study was carried out with 29 patients, 12 patients to whom was placed a carotid stent and 17 control patients, Odds ratio was calculated for risk factors: high blood pressure, diabetes, cancer, smoking and dyslipidemia. And then multivariate analysis was performed with the same variables. Results. For the risk factors with statistical significance for carotid ulcer were dyslipidemia and cancer, and for stent placement, smoking, and clinically presented as a transient ischemic attack. For the multivariate analysis, the only factor associated with stent placement was smoking. Conclusions. Of the entire range of risk factors associated with cerebrovascular disease, tobacco use is the factor most strongly associated with a patient with carotid disease ending up in endovascular treatment. So prevention or lifestyle modification is the best tool to avoid these outcomes. VL - 6 IS - 1 ER -
Information
Email: