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  • Title: A High Prevalence of Intracranial Stenosis in Patients with Coronary Artery Disease and the Diagnostic Value of Transcranial Duplex Sonography.
    Author: Valaikiene J, Ryliskyte L, Valaika A, Puronaite R, Dementaviciene J, Vaitkevicius A, Badariene J, Butkuviene I, Kalinauskas G, Laucevicius A.
    Journal: J Stroke Cerebrovasc Dis; 2019 Apr; 28(4):1015-1021. PubMed ID: 30630758.
    Abstract:
    BACKGROUND: 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). METHODS: Three hundred and eighty-nine patients with angiographically-confirmed, severe CAD were included prospectively. All of them were examined using extracranial and TCCS. RESULTS: 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. CONCLUSIONS: 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.
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