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Luitse, Merel J.A.; Velthuis, Birgitta K.; Dauwan, Meenakshi; Dankbaar, Jan Willem; Biessels, Geert Jan; Kappelle, L. Jaap; Majoie, C.B.; Roos, Y.B.; Duijm, L.E.; Keizer, K.; van der Lugt, A.; Dippel, D.W.; Droogh-de Greve, K.E.; Bienfait, H.P.; van Walderveen, M.A.; Wermer, M.J.; Lycklama à Nijeholt, G.J.; Boiten, J.; Duyndam, D.A.; Kwa, V.I.; Meijer, F.J.; van Dijk, E.J.; Kesselring, F.O.; Hofmeijer, J.; [...]

Residual High-Grade Stenosis After Recanalization of Extracranial Carotid Occlusion in Acute Ischemic Stroke

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  • Medientyp: E-Artikel
  • Titel: Residual High-Grade Stenosis After Recanalization of Extracranial Carotid Occlusion in Acute Ischemic Stroke
  • Beteiligte: Luitse, Merel J.A.; Velthuis, Birgitta K.; Dauwan, Meenakshi; Dankbaar, Jan Willem; Biessels, Geert Jan; Kappelle, L. Jaap; Majoie, C.B.; Roos, Y.B.; Duijm, L.E.; Keizer, K.; van der Lugt, A.; Dippel, D.W.; Droogh-de Greve, K.E.; Bienfait, H.P.; van Walderveen, M.A.; Wermer, M.J.; Lycklama à Nijeholt, G.J.; Boiten, J.; Duyndam, D.A.; Kwa, V.I.; Meijer, F.J.; van Dijk, E.J.; Kesselring, F.O.; Hofmeijer, J.; [...]
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2015
  • Erschienen in: Stroke
  • Sprache: Englisch
  • DOI: 10.1161/strokeaha.114.007169
  • ISSN: 1524-4628; 0039-2499
  • Schlagwörter: Advanced and Specialized Nursing ; Cardiology and Cardiovascular Medicine ; Neurology (clinical)
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>Residual stenosis after recanalization of an acute symptomatic extracranial occlusion of the internal carotid artery (ICA) might be an indication for carotid endarterectomy. We evaluated the proportion of residual high-grade stenosis (≥70%, near occlusions not included) on follow-up imaging in a consecutive series of patients with an acute symptomatic occlusion of the extracranial ICA.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>We included patients participating in the Dutch Acute Stroke Study (DUST), who had an acute symptomatic occlusion of the extracranial ICA that was diagnosed on computed tomographic angiography within 9 hours after onset of neurological symptoms. Follow-up imaging of the carotid artery had to be available within 7 days after admission.</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p>Of the 1021 patients participating in DUST between May 2009 and May 2013, an acute symptomatic occlusion of the extracranial ICA was found in 126 (12.3%) patients. Follow-up imaging was available in 86 (68.3%) of these patients. At follow-up, a residual stenosis of &lt;30% was found in 15 (17.4%; 95% confidence interval, 10.8–26.9) patients, a 30% to 49% stenosis in 3 (3.5%; 95% confidence interval, 0.8–10.2) patients, a 50% to 69% stenosis in 2 (2.3%; 95% confidence interval, 0.1–8.6) patients, and a ≥70% stenosis in 14 (16.3%; 95% confidence interval, 9.8–25.6) patients. A near or persistent occlusion was present in the remaining 52 (60.5%) patients.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>A residual high-grade stenosis of the extracranial ICA occurs in 1 of 6 patients with a symptomatic occlusion in the acute stage of cerebral ischemia. Because this may have implications for secondary prevention, we recommend follow-up imaging in these patients within a week after the event.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT00880113. </jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang