Computed tomography angiography versus ultrasound in patients with ischemic stroke owing to carotid artery disease

Objectives This work aimed to assess the efficacy of computed tomography angiography (CTA) in comparison with ultrasound carotid duplex (USCD) to find out, assess, and evaluate carotid artery disease in patients with ischemic stroke. Background Stroke is the third most common cause of death worldwide. Strokes can be ischemic or hemorrhagic. Carotid artery stenosis is considered a major cause of ischemic stroke. Patients and methods A cross-sectional study was done on 50 patients with ischemic stroke to compare ultrasound duplex of the carotid system and CTA regarding stenosis percentage and degree and the plaque characteristics (site, dimensions, nature, number, and hemodynamic affection), including intima-media thickness. All of the study procedures were carried out and approved by the ethics committee of the Faculty of Medicine, Menoufia University, in June 2021. Results Regarding the degree of stenosis, USCD showed more stenosis percentage than CTA (47 vs. 43%, respectively, for first lesion, 60 vs. 40%, respectively, for second lesion, 55 vs. 45%, respectively, for third lesion, and 80 vs. 20%, respectively, for fourth lesion). Regarding the plaque nature, USCD showed almost close results to CTA (47% soft atheromatous plaques vs. 46% in CTA, and 50% calcified plaques in both). Regarding the plaque number, USCD detects more plaques than CTA (20 cases have no plaques in CTA vs. nine in USCD). Conclusion The study recommends the combination of USCD and CTA in patients with ischemic stroke, as CTA is more sensitive regarding the degree of stenosis and USCD provides more descriptive data about the plaque characteristics.