From the Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry (J.K.-T.), University of Alberta, Edmonton, Canada.
Department of Biomedical Engineering (A.W.), University of Alberta, Edmonton, Canada.
Stroke. 2020 Jan;51(1):311-314. doi: 10.1161/STROKEAHA.119.027272. Epub 2019 Nov 22.
Background and Purpose- An ipsilateral mild carotid stenosis, defined as plaque with <50% luminal narrowing, is identified in nearly 40% of patients with embolic stroke of undetermined source and could represent an unrecognized source of atheroembolism. We aimed to summarize data about the frequency of mild carotid stenosis with high-risk features in embolic stroke of undetermined source. Methods- We searched Pubmed and Ovid-Embase for studies reporting carotid plaque imaging features in embolic stroke of undetermined source. The prevalence of ipsilateral and contralateral mild carotid stenosis with high-risk features was pooled using random-effect meta-analysis. Results- Eight studies enrolling 323 participants were included. The prevalence of mild carotid stenosis with high-risk features in the ipsilateral carotid was 32.5% (95% CI, 25.3-40.2) compared with 4.6% (95% CI, 0.1-13.1) in the contralateral carotid. The odds ratio of finding a plaque with high-risk features in the ipsilateral versus the contralateral carotid was 5.5 (95% CI, 2.5-12.0). Conclusions- Plaques with high-risk features are 5 times more prevalent in the ipsilateral compared with the contralateral carotid in embolic stroke of undetermined source, suggesting a relationship to stroke risk.
背景与目的-在不明来源栓塞性卒中患者中，近 40%存在同侧轻度颈动脉狭窄（定义为管腔狭窄<50%的斑块），这可能代表着尚未识别的动脉粥样硬化栓子来源。我们旨在总结不明来源栓塞性卒中患者中伴有高危特征的轻度颈动脉狭窄的频率数据。方法-我们在 Pubmed 和 Ovid-Embase 上检索了报道不明来源栓塞性卒中颈动脉斑块影像学特征的研究。使用随机效应荟萃分析汇总同侧和对侧伴有高危特征的轻度颈动脉狭窄的患病率。结果-纳入了 8 项共 323 名参与者的研究。同侧颈动脉伴有高危特征的轻度颈动脉狭窄的患病率为 32.5%（95%可信区间，25.3-40.2），而对侧颈动脉的患病率为 4.6%（95%可信区间，0.1-13.1）。同侧颈动脉斑块伴有高危特征与对侧颈动脉相比，其发生的比值比为 5.5（95%可信区间，2.5-12.0）。结论-在不明来源栓塞性卒中患者中，同侧颈动脉斑块伴有高危特征的患病率是对侧颈动脉的 5 倍，提示与卒中风险有关。
