Valaikiene Jurgita, Ryliskyte Ligita, Valaika Arunas, Puronaite Roma, Dementaviciene Jurate, Vaitkevicius Arunas, Badariene Jolita, Butkuviene Irena, Kalinauskas Gintaras, Laucevicius Aleksandras
Centre of Neurology, Vilnius University Hospital Santaros klinikos; Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Centre of Cardiology and Angiology, Vilnius University Hospital Santaros klinikos; Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
J Stroke Cerebrovasc Dis. 2019 Apr;28(4):1015-1021. doi: 10.1016/j.jstrokecerebrovasdis.2018.12.023. Epub 2019 Jan 8.
According to the data from the population-based Rotterdam study, intracranial carotid artery calcification detected by computed tomography is very common and contributed to 75% of all strokes. The aim of the present study was to estimate the prevalence of intracranial stenosis (IS) using noninvasive transcranial color-coded duplex sonography (TCCS) in neurologically asymptomatic patients with coronary artery disease (CAD).
Three hundred and eighty-nine patients with angiographically-confirmed, severe CAD were included prospectively. All of them were examined using extracranial and TCCS.
Out of 389 patients (age 66.7 ± 9.2, 39-88), 237 (61%) were diagnosed with 3 vessels disease and 152 patients (39%) with left stem disease with/without 3 vessels damage. Transcranial sonography revealed at least 1 IS in 63.6% of echo positive patients (220/346). IS was found in 127 (61.4%) patients with 3 vessels disease, 20 patients (58.8%) with isolated left stem disease, and 73 patients (69.5%) with 3 vessels and left stem disease (P = .305). In the case of significant (≥50%) extracranial internal carotid artery stenosis, intracranial stenosis were detected in 84.8% (50 of 59), in the case of mild (<50%) stenosis, in 59.2% (170 of 287), P < .001.
It was found that two thirds of patients with advanced CAD have a silent IS. TCCS is a reliable method for the evaluation of intracranial atherosclerosis in such patients in order to gain useful information about cerebrovascular disease as a risk factor for stroke.
根据基于人群的鹿特丹研究数据，计算机断层扫描检测到的颅内颈动脉钙化非常常见，占所有中风的75%。本研究的目的是使用无创经颅彩色编码双功超声（TCCS）评估冠状动脉疾病（CAD）神经无症状患者的颅内狭窄（IS）患病率。
前瞻性纳入389例经血管造影证实的严重CAD患者。所有患者均接受颅外和TCCS检查。
在389例患者（年龄66.7±9.2，39 - 88岁）中，237例（61%）被诊断为三支血管病变，152例（39%）为左主干病变伴或不伴有三支血管损伤。经颅超声显示，在63.6%的回声阳性患者（220/346）中至少有1处IS。在127例（61.4%）三支血管病变患者、20例（58.8%）孤立性左主干病变患者和73例（69.5%）三支血管和左主干病变患者中发现了IS（P = 0.305）。在颅外颈内动脉严重（≥50%）狭窄的情况下，颅内狭窄的检出率为84.8%（59例中的50例），在轻度（<50%）狭窄的情况下，检出率为59.2%（287例中的170例），P < 0.001。
发现三分之二晚期CAD患者存在无症状颅内狭窄。TCCS是评估此类患者颅内动脉粥样硬化的可靠方法，以便获取有关作为中风危险因素的脑血管疾病的有用信息。
