Japanese Journal of Stroke
Online ISSN : 1883-1923
Print ISSN : 0912-0726
ISSN-L : 0912-0726
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A sensitive screening method for detecting asymptomatic carotid artery stenosis
Yumiko YamaokaYumi SuzukiKiyomi NishiyamaHiroko NakanishiYasuko MitamuraOrie KanekoYuriko MikiMiwa IkarashiNorifumi Yamakawa
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2020 Volume 42 Issue 1 Pages 8-13

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Abstract

Background and Purpose: Asymptomatic carotid artery stenosis (ACAS) is associated with not only ipsilateral stroke but also other vascular diseases or vascular death. Also, Japanese REduction of Atherothrombosis for Continued Health registry presented that both ACAS ≥ 70% and ankle-brachial index (ABI) <0.9 were predisposing factors for stroke excluding transient ischemic attack (TIA). Although, the reported prevalence rate of ACAS (≥70%) was 0.5–3%. We aimed to develop a sensitive screening method for detecting ACAS (≥70%). Methods: We analyzed 1096 patients who underwent both ultrasonography study (US) and ABI measurements during the period of 2014–2017. Extracranial Internal carotid artery stenosis (≥70%) was screened by US and confirmed by MRA. We retrospectively analyzed 39 (ACAS group) and 1057 patients (non-ACAS group). We also compared ABI values between two groups. Results: A total of 39 patients was presented with ACAS (≥70%). Binominal logistic regression analysis revealed that past history of ischemic vascular disease was the only predictive factor for ACAS (≥70%) (p < 0.001). Also, the number of patients presenting ABI <1.0 in the ACAS group was significantly higher than that in the non-ACAS group (p < 0.001). The detection rate of ACAS(≥70%) was 3.6% among 1096 patients. When screened by ABI (<1.0) and by having a history of ischemic vascular disease, detection rate of ACAS (≥70%) was increased up to 9.2%. Conclusion: We developed a simple two-step screening method for detecting ACAS (≥70%).

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© 2020 The Japan Stroke Society
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