Relationship Between Extracranial Carotid Artery Disease And OCSP Classification In Ischemic Stroke

ObjectiveTo investigate the relations between extracranial carotid artery disease andOxfordshire Community Stroke Project (OCSP), in order to provide newbreakthrough point and reference for individualized treatment and secondaryprevention of ischemic stroke.Method160cases of patients with acute ischemic stroke admitted to hospital wereselected in department of neurology of the first affiliated hospital of ZhengzhouUniversity from February in2010to November in2011. All of the patients werewithin a week from onset to admission. They were first-ever or recurrent stroke whohad no neurologic deficits prior to admission. They were classified according toOCSP classification standard and clinical symptoms, and were divided into threegroups of A,B,C. There were9cases with total anterior circulation infarcts (TACI)and67cases with Partial anterior circulation infarcts (PACI), a total of76cases, inGroup A. There were40patients with posterior circulation infarcts (POCI) in GroupB and44cases with lacunar infarcts (LACI) in Group C. All of patients withischemic stroke were observed the characteristics of extracranial carotid atherosclerosis by color doppler ultrasound,were recorded the information of theseverity of extracranial carotid stenosis and the location, shape, the echo intensity,texture of carotid atherosclerotic plaques. All data were analyzed by SPSSl7.0software.Results1．In160patients with ischemic stroke, the rate of carotid artery plaque detectionwas68.1%, the incidence of moderate and severe carotid stenosis was12.5%.2．In Group A, the rate of carotid atherosclerotic plaque detection was77.6%andthe rate of unstable plaque detection was59.1%.It was higher than Group B andGroup C (P <0.05). There was no statistical significance between Group B andGroup C (P>0.05).3．Carotid atherosclerotic plaques are more likely to appear in carotid bifurcation.There was no statistical significance among Group A, Group B and Group C (P>0.05).4．There were299carotid atherosclerotic plaques discovered in160patients withischemic stroke. The number of patients with unstable plaques in Group A was morethan Group B (P <0.01) and Group C (P <0.05). There was no statisticalsignificance between Group B and Group C (P>0.05).5．24cases were checked out four or more than four carotid atheroscleroticplaques in Group A. It was higher than Group B and Group C (P <0.05). There wasno statistical significance between Group B and Group C (P>0.05).6．The rate of carotid stenosis of Group A, Group B and Group C was59.2%,42.5%and43.2%respectively, there was no statistical significance among Group A,Group B and Group C (P>0.05). The incidence of moderate and above moderatecarotid stenosis was22.4%, it was higher than2.5%of Group B (P <0.01) and4.5%of Group C (P <0.05). There was no statistical significance between Group B andGroup C (P>0.05). Conclusion1．The characteristics of extracranial carotid atherosclerosis of patients withischemic stroke are the high incidence of carotid atherosclerotic plaques and the lowincidence of severe extracranial carotid artery stenosis relatively.2．Different subtypes in OCSP classification have different characteristics ofextracranial carotid atherosclerosis. Among different subtypes in OCSP classification,carotid atherosclerotic plaques, especially the unstable plaques are related to PACIand TACI to some extent.3. OCSP classification has certain predictive value for severe extracranial carotidstenosis. The patients with TACI and PACI may have severe extracranial carotidstenosis.