Key result
Symptomatic and asymptomatic carotid near-occlusions demonstrated very similar angiographic appearances, with no significant difference in the prevalence of full collapse (42% vs 45%).
Why the study?
Previous studies had not compared the angiographic appearance of symptomatic and asymptomatic carotid near-occlusion.
Does symptomatic status correlate with more severe angiographic appearance in patients with carotid near-occlusion?
Observational (n=645)
Blinded to clinical data and degree of stenosis
No
Does symptomatic status correlate with more severe angiographic appearance in patients with carotid near-occlusion?
Absolute Event Rate: 42% vs 45%
p-value: p=0.87
Symptomatic and asymptomatic carotid near-occlusions have very similar angiographic appearances on CT-angiography, challenging the hypothesis that stroke in near-occlusion with full collapse is primarily due to cerebral hypoperfusion.
Angiographic appearance alone should not inform management of carotid near-occlusion; leaves open the prognostic value of full collapse.
The aim of this study was to compare the angiographic appearance of symptomatic and asymptomatic carotid near-occlusion. We have found no such previous study. The study hypothesis was that among symptomatic patients with ≥ 50% carotid stenosis, near-occlusion is more common and near-occlusions are more severe than among asymptomatic persons with ≥ 50% carotid stenosis. We reassessed consecutive CTAs from 4042 persons, 645 had ≥ 50% carotid stenosis, and 385 (60%) symptomatic. Near-occlusion was similarly common in symptomatic (105, 27%) and asymptomatic (56, 24%) cases. Among near-occlusions, the angiographic appearance was very similar between symptomatic and asymptomatic cases: mean stenosis lumen diameter (0.7 mm), distal ICA diameter (2.1 mm), and ECA ratio (0.79) were the same in both groups. Mean ICA ratio (0.46 and 0.48) and share of full collapse was very similar (45% and 42%). These findings add to the pathophysiological understanding of carotid near-occlusion.
No takes yet. Share an insight, caveat, or question.
Kellomäki et al. (2022) conducted an observational in Carotid stenosis (≥50%) and near-occlusion (n=645). Symptomatic status vs. Asymptomatic status was evaluated on Share of full collapse among near-occlusions (p=0.87). Symptomatic and asymptomatic carotid near-occlusions demonstrated very similar angiographic appearances, with no significant difference in the prevalence of full collapse (42% vs 45%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: