| Objective: (1) Carotid artery stenosis (CAS) accounts for 15 % of ischemic stroke. Up to 13 percent of CAS patients with stenosis degree greater than 70 % will develop into ischemic stroke. Therefore, a method, which can detect CAS early and rapidly and assess stenosis location and degree accurately, will definitely reduce the incidence of ischemic stroke. The common methods for CAS examination include Digital Subtraction Angiography (DSA), Magnetic Resonance Angiography (MRA), Spiral Computer Tomography Angiography (SCTA) and Color Doppler Ultrasound (CDU). Among these, DSA is the gold standard for diagnosis of CAS. However, the invasiveness and expensiveness limit the wide use of DSA. In the present study, we evaluated the clinical value of CDU in diagnosis of extra cranial internal CAS, taking DSA as a standard. (2) Vascular stent implantation, which can significantly attenuate stenosis-induced symptoms and decrease the risk of ischemic stroke, is an effective way to treat extra cranial artery stenosis. However, the stroke recurrence and restenosis within the stent are the two disadvantages for stenting treatment. Statin therapy has been proved to block the multiple steps of stent stenosis development. Statins can reduce the levels of low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC) and increase high-density lipid protein cholesterol (HDL-C) levels. Recently, the studies on carotid artery atherosclerotic plaque revealed a close relationship between stroke and carotid artery plaque while statins can stabilize atherosclerosis plaque, attenuate atherosclerosis, and even reverse the original disease. In addition, statin therapy reduces the stroke incidence and mortality of atherosclerotic patients as well. In order to investigate the effects of statins on ischemic cerebrovascular disease, here we examined cerebral artery stent restenosis, plaque stability and lipid levels study after treatment of atorvastatin. Methods: (1) 506 patients with ischemic cerebrovascular disease from July 2006 to October 2009 were analyzed retrospectively, who all underwent the examination of DSA and carotid artery CDU. The results of carotid artery CDU were compared with those of DSA in diagnosis of CAS and assessment of occlusive degree. Among the 506 cases, 113 were cerebral artery stenosis stent, confirmed by DSA as carotid stenosis and other arterial stenosis. (2) Changes in carotid artery plaque areas and lipid levels were compared before and after atorvastatin treatment. Results: (1) Compared with DSA results, the sensitivity of carotid artery CDU for diagnosis of CAS was 74.6%, specificity was 99.4% and accuracy was 96.4%. The percentage of missed diagnosis was 25.4% and that of misdiagnosis was 0.56 %. (2) On the other hand, the areas of carotid plaque before and after atorvastatin treatment were 34.16±27.58 and 24.67±21.19, respectively; Blood lipid level were: TC, 4.11±0.67 and 3.38±0.57; TG, 2.37±1.08 and 1.70±0.72; LDL-C, 2.58±0.55 and 1.70±0.39; HDL-C, 0.88±0.18 and 1.15±0.23, respectively. Conclusion: (1) The carotid artery CDU is an effective diagnostic method for CAS, which can be used in early screening of extra cranial artery stenosis. However, the carotid artery CDU cannot replace DSA since the latter functions in determining the accurate degree of vascular stenosis before intervention or surgical treatment. (2) Atorvastatin can regulate the levels of blood lipid, reduce plaque areas, attenuate atherosclerosis, increase plaque stability, and prevent occurrence of cardiovascular events. For its safety, effectiveness, well toleration and few side effects, atorvastatin can be considered as a conventional medication for patients with carotid atherosclerosis.
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