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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Ulcerated carotid plaques with ultrasonic echolucency are causatively associated with thromboembolic cerebrovascular events
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Ulcerated carotid plaques with ultrasonic echolucency are causatively associated with thromboembolic cerebrovascular events

机译：具有超声回声的溃疡性颈动脉斑块与血栓栓塞性脑血管事件有因果关系

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The presence of ulcerated carotid plaques is a risk factor for ischemic stroke, which is associated with thromboembolism. We evaluated the relationship between ulcerated carotid plaques and cerebrovascular events in patients with acute ischemic stroke or transient ischemic attack. We extracted 48 consecutive patients with ulcerated carotid plaques from a cohort of 1111 patients with acute ischemic stroke or transient ischemic attack. All patients were evaluated by carotid ultrasonography and diffusion-weighted magnetic resonance imaging. We defined thromboembolic events by excluding potential cardiac sources of embolism, stroke in posterior circulation, contralateral lesions, and single and small (<1.5 cm) subcortical lesions, and we considered the remaining patients with cortical lesions or multiple or large subcortical lesions as having experienced a thromboembolic cerebrovascular event. We compared ultrasonographic findings in the patients with and those without a thromboembolic cerebrovascular event. A relationship with thromboembolic events was suspected in 10 patients (21%) with ulcerated carotid plaques. The proportion of smokers was significantly higher in the group of patients with a thromboembolic event (90% vs 53%; P =.03). Logistic regression demonstrated a significant association between thromboembolic events and the presence of echolucent ulcerated plaques (odds ratio, 9.34, 95% confidence interval, 1.65-53.0), even though maximum intima-media thickness and other variables of ulcerated plaques (eg, depth of ulcers, thickness of the plaque, or the degree of stenosis) did not differ significantly between the 2 groups. Our findings indicate that although cerebrovascular events are closely associated with echolucent ulcerated carotid plaques, the prevalence of thromboembolism was not very high (～20%) in our cohort of Japanese patients with ulcerated carotid plaques.
机译：颈动脉斑块溃疡的存在是缺血性中风的危险因素，与血栓栓塞有关。我们评估了急性缺血性卒中或短暂性脑缺血发作患者颈动脉斑块溃疡与脑血管事件之间的关系。我们从1111例急性缺血性中风或短暂性脑缺血发作患者中提取了48例连续的颈动脉斑块溃疡患者。所有患者均通过颈动脉超声检查和弥散加权磁共振成像进行评估。通过排除潜在的心脏栓塞，后循环中风，对侧病变以及单个和小的（<1.5 cm）皮层下病变，我们定义了血栓栓塞事件，我们认为剩下的皮质病变或多发或大皮质下病变的患者血栓栓塞性脑血管事件。我们比较了有和没有血栓栓塞性脑血管事件的患者的超声检查结果。怀疑有10例（21％）颈动脉溃疡斑块与血栓栓塞事件有关。在发生血栓栓塞事件的患者中，吸烟者的比例明显更高（90％比53％; P = .03）。 Logistic回归表明，即使最大内膜中膜厚度和溃疡斑块的其他变量（如溃疡斑的深度），血栓栓塞事件与回声溃疡斑块的存在也有显着相关性（优势比，9.34，95％置信区间，1.65-53.0）。两组之间的溃疡，斑块厚度或狭窄程度无明显差异。我们的研究结果表明，尽管脑血管事件与回声透明的溃疡性颈动脉斑块密切相关，但在我们日本颈动脉溃疡性斑块患者中，血栓栓塞的发生率不是很高（约20％）。

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