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We looked for risk factors for significant carotid stenosis (CS) in patients with ischemic stroke. We included all patients treated for an ischemic stroke/transient ischemic attack (TIA) and had a carotid duplex done from August 2006 to November 2008. A total of 458 patients were included. Significant CS of the extracranial internal carotid artery and the common carotid artery were found in 10.9% (50 of 458 patients). Age (≥65 years old) was the independent risk factor for CS (OR 4.0, P < .0001). The patients with a CS had more history of coronary artery disease (12% vs 8%, P = .32), prior ischemic stroke (18% vs 11%, P = .17), atrial fibrillation (10% vs 5%, P = .19), and smoking (28% vs 24%, P = .18) compared with the patients without CS. The evaluation of the carotid arteries should be recommended in patients with ischemic stroke/TIA, especially in the older ones (≥65 years old). [ABSTRACT FROM PUBLISHER]

We assessed the prevalence of carotid stenosis (CS) and peripheral arterial disease (PAD) in patients with coronary artery disease (CAD) to determine the relationship between these conditions in a Thai population. All patients with coronary angiography during June 2008 and August 2009 were studied. Carotid duplex and ankle-brachial index (ABI) were performed. One hundred and seventy-seven patients were studied (95 men, mean age of 65). Carotid stenosis and PAD were diagnosed in 16 patients (9%) and 68 patients (38.4%), respectively. The presence of carotid bruit and older age were independent predictors of CS and PAD, respectively. There was no correlation between the presence of CS/PAD and the extent of coronary artery lesions. Although CS was uncommon in patients with CAD, the patients with cervical bruit should be screened for CS. Prevalence of PAD was high, confirming the presence of diffuse atherosclerosis in many patients with CAD. [ABSTRACT FROM AUTHOR]

Abstract: Stroke is a leading cause of death and morbidity in Thailand. The purpose of this study was to look for prevalence of significant extracranial carotid stenosis (ECCS) in Thai ischemic stroke/transient ischemic attack (TIA) patients and baseline characteristics of this subgroup. Methods: All acute/subacute ischemic stroke/TIA patients who were treated at Thammasat hospital and had carotid duplex done, during August 2006–July 2007, were included. Carotid duplex studies were performed in all clinically stable patients. The degree of stenosis was defined according to the standard velocity criteria. Stroke subtypes were classified by TOAST criteria: large-artery atherosclerosis (LAA), cardioembolism (CE), small-artery occlusion (SAO), stroke of other determined cause (OC) and stroke of undetermined cause (UND). Results: One-hundred and eighty-four cases were included. Prevalence of significant ECCS was 9.2%. SAO subtype was the most common stroke subtype in our study (45%). Significant ECCS was found in 18.4%, 6% and 8.3% patients with LAA, SAO and CE stroke subtype, respectively. Conclusion: Significant ECCS in Thai ischemic stroke/TIA patients is uncommon. Low prevalence of coronary artery disease and peripheral artery disease in Thai stroke patients and/or high SAO stroke subtype in our patients may explain this. [Copyright &y& Elsevier]

Background: Extracranial carotid stenosis can be diagnosed by velocity criteria of carotid duplex. Whether they are accurately applied to define severity of internal carotid artery (ICA) stenosis in Asian patients needs to be proved. The purpose of this study was to evaluate the accuracy of 2 carotid duplex velocity criteria in defining significant carotid stenosis., Methods: Carotid duplex studies and magnetic resonance angiography were reviewed. Criteria 1 was recommended by the Society of Radiologists in Ultrasound; moderate stenosis (50%-69%): peak systolic velocity (PSV) 125-230 cm/s, diastolic velocity (DV) 40-100 cm/s; severe stenosis (>70%): PSV greater than 230 cm/s, DV greater than 100 cm/s. Criteria 2 used PSV greater than 140 cm/s, DV less than 110 cm/s to define moderate stenosis (50%-75%) and PSV greater than 140 cm/s, DV greater than 110 cm/s for severe stenosis (76%-95%)., Results: A total of 854 ICA segments were reviewed. There was moderate stenosis in 72 ICAs, severe stenosis in 50 ICAs, and occlusion in 78 ICAs. Criteria 2 had slightly lower sensitivity, whereas higher specificity and accuracy than criteria 1 were observed in detecting moderate stenosis (criteria 1: sensitivity 95%, specificity 83%, accuracy 84%; criteria 2: sensitivity 92%, specificity 92%, and accuracy 92%). However, in detection of severe ICA stenosis, no significant difference in sensitivity, specificity, and accuracy was found (criteria 1: sensitivity 82%, specificity 99.57%, accuracy 98%; criteria 2: sensitivity 86%, specificity 99.68%, and accuracy 99%)., Conclusions: In the subgroup of moderate stenosis, the criteria using ICA PSV greater than 140 cm/s had higher specificity and accuracy than the criteria using ICA PSV 125-230 cm/s. However, there was no significant difference in detection of severe stenosis or occlusion of ICA., (Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.)

Background: Strokes constitute a major public healthcare problem in Thailand. Stroke prevalence in Thailand is high, but lower than in highly developed countries, probably due to the high fatality rate here. Carotid pathology is known to be associated with strokes, and carotid doppler ultrasonography (CDU) is a powerful tool for use in evaluating atherosclerosis of the carotid artery., Objective: To evaluate carotid imaging pathology by CDU in stroke patients., Material and Method: This was a retrospective study of 170 stroke patients who underwent CDU in Rajavithi Hospital between January 2011 and May 2016., Results: In all, there were 170 stroke patients with mean age of 63.92±13.97 years (21 to 91 years old); 61.2% were men, and 38.8% were women. Mean carotid IMT of the right and left common carotid artery were 1.08±0.55 mm and 1.11±0.58 mm respectively. Plaque levels at the right and left internal carotid artery were 1.51±0.81 mm and 1.600.86 mm, respectively, and total occlusion of carotid artery was found in 12 patients. Follow-up studies were obtained in 10 cases of whom all had progressive disease: in one patient, the progression of carotid stenosis increased from 70% stenosis to total occlusion, and in another from 53% stenosis to total occlusion. Total occlusion of carotid artery was found in 14 patients., Conclusion: Most of these stroke patients had carotid pathology. Many of them had normal carotid velocity, but increasing intima-media thickness and plaque of varying morphology. There were varying degrees of vessel stenosis ranging from no significant stenosis to more than 50% stenosis, 50 to 69% stenosis, more than 70% stenosis, near occlusion and total occlusion.