There are vascular risk factors known to be associated with stroke. These risk factors have been shown to either directly or indirectly lead to stroke. The risk factors include hypertension (HT), diabetes mellitus (DM), smoking, hyperlipidaemia, ischemic heart disease (IHD) and atrial fibrillation (AF). Studies have shown that carotid atherosclerosis is a cause of stroke. Extracranial carotid atherosclerosis accounts for up to 40% of the ischemic strokes in the Western countries. The latest stroke guidelines recommend the routine use of Ultrasound Carotid Doppler to assess for extracranial carotid artery atherosclerotic diseases (carotid intima media thickness, plaques, carotid stenosis) in these patients. A previous study emphasized the value of carotid ultrasonography in the detection of early extracranial carotid atherosclerosis.
Part of the book: Peripheral Arterial Disease
Management of transient ischemic attack (TIA) is important because potentially fatal ischemic strokes can be prevented. Detection of extracranial carotid atherosclerosis in these patients is beneficial because medical therapy can be given, and in certain cases, surgery can be performed. In a Chinese study conducted on the patients with TIA, only 19% of them had extracranial carotid atherosclerosis. Another study was conducted to compare the location and the severity of atherosclerotic lesions between Americans and the Japanese who presented with carotid system TIA. This study showed that 85% of the American patients had extracranial carotid stenosis (stenosis ≥50%). However, only 16.7% of the Japanese patients had similar lesions.
Part of the book: Peripheral Arterial Disease