Frequency and Pattern of Carotid Artery Stenosis in Ischemic Stroke Patients

Objective: Ischemic stroke is a major contributor of global morbidity and mortality and is often associated with carotid artery stenosis, which can impact the extent of cerebral infarction and clinical outcomes. Early detection of significant stenosis is essential for prompt intervention and effective risk stratification. This study was conducted to assess the frequency and patterns of carotid artery stenosis in patients with acute ischemic stroke. Methods: A cross-sectional study was conducted over six months at the Department of Neurology, Hayatabad Medical Complex, Peshawar, during July 2024 to December 2024, after ethical approval from the Institutional Review Board and CPSP. A total of 150 patients aged 20–75 years were recruited via consecutive sampling. Clinical evaluation, CT brain, and carotid Doppler ultrasound were performed to confirm ischemic stroke and to assess stenosis. Patients with prior carotid surgery, hemorrhagic stroke, brain injury, neck masses, cervical deformities, or inability to undergo Doppler were excluded. Demographic, clinical, and vascular risk factors were recorded, and data were analyzed using SPSS version 22, quantitative variables were expressed as mean ± SD, qualitative variables as frequencies and percentages, and associations assessed with chi-square tests (p <0.05). Results: Among 150 patients, ischemic changes on CT brain were present in 87 (58.0%) patients. Right-sided ≥50% stenosis was observed in 33 (22%) and left-sided in 41 (27%), while complete occlusion was rare (6 4.0% right and 2 1.3% left). Hypertension 102 (68%) and diabetes 61 (40.7%). Higher systolic and diastolic blood pressures and confusion 25(28.7%) were significantly associated with ischemic changes (p = 0.001). Conclusion: It was predicted in our study that majority of the patients exhibited <50% of stenosis, while complete occlusion was infrequent. However, significant association existed between ischemic changes with left carotid artery stenosis which was insignificant in case of right side.